What’s the 2+1+1? Event-driven oral pre-exposure prophylaxis to prevent HIV for men who have sex with men: Update to WHO’s recommendation on oral PrEP

15 August 2019

An increasing number of countries are adopting policies endorsing PrEP for HIV prevention. Emerging evidence from clinical research that different dosing strategies can be effective provides an opportunity to offer flexibility, choice and convenience to individuals who can benefit from PrEP and is considered by WHO in updating its guidance to countries. Based on the available evidence published so far, this technical brief updates the current WHO recommendation on oral PrEP to include an option of event-driven dosing for men who have sex with men.

Featured Resources

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Global Acute HIV Infection Algorithm Job Aids for Providers

This tool can assist providers in assessing acute HIV infection (AHI) in clients using oral PrEP, PrEP ring, and CAB PrEP by offering guidance through three steps: HIV testing, recent exposure to HIV assessment, and AHI assessment. Providers are encouraged to use clinical judgement and defer to national guidance as needed.

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Daily Oral PrEP, PrEP Ring, and CAB PrEP Template Guidelines (Spanish)

The intent of this document is to provide adaptable guidelines to support the development and adoption of national guidelines that align with World Health Organization (WHO) pre-exposure prophylaxis (PrEP) recommendations and guidance, including those for tenofovir disoproxil fumarate (TDF)-based oral PrEP, the monthly dapivirine vaginal ring (“PrEP ring” or “the ring”), and injectable cabotegravir (CAB…

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HIV Prevention User Journey Tool

The HIV Prevention Journey Tool was developed to support adolescent girls and young women to explore methods that would align with their lifestyle, needs and personal preferences; and support healthcare providers to provide informed counseling based on client needs. The digital tool, which has been optimized for use on mobile devices, can be accessed here.…

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2024 Q3 Global PrEP Tracker

AVAC’s Global PrEP Tracker offers two views on PrEP uptake around the world. Visit data.prepwatch.org for a dynamic map-based tool to explore trends in oral PrEP use globally as countries introduce and scale up PrEP programs. For insights on the full scope of PrEP use around the world, the PrEP Tracker as a spreadsheet offers…

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Oral PrEP, PrEP Ring, and CAB PrEP Template Guidelines (English)

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Pre-Exposure Prophylaxis Implementation Gaps among People Vulnerable to HIV Acquisition: A cross-sectional analysis in two communities in western Kenya, 2021–2023

This article, from Journal of the International AIDS Society, examines PrEP awareness, uptake, and persistence among participants enrolling into an HIV incidence cohort in Kenya.

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Initiation and Continued Use of Oral Pre-Exposure Prophylaxis among Pregnant and Postpartum Women in South Africa (PrEP-PP): A demonstration cohort study

This article from The Lancet HIV describes the results of a demonstration study in South Africa, PrEP-PP, to integrate oral PrEP provision into public clinics offering antenatal and postnatal care to pregnant and lactating people.

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Acceptability of Six-Monthly PrEP Dispensing Supported with Interim HIV Self-Testing to Simplify PrEP Delivery in Kenya: Findings from qualitative research

This article from BMC Health Services Research discusses the results of a pilot in Kenya to explore the acceptability of dispensing PrEP twice a year, with interim HIV self-testing, versus quarterly, with clinic-based HIV testing.

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Dynamic Choice HIV Prevention with Cabotegravir Long-acting Injectable in Rural Uganda and Kenya: A randomised trial extension

This article from The Lancet HIV discusses the results of the SEARCH dynamic choice study conducted in Kenya and Uganda, comparing outcomes between one group offered a choice between oral PrEP, post-exposure prophylaxis, and cabotegravir for PrEP, and a second group receiving the standard of care.

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Adolescent Girls and Young Women Overcoming Adherence Challenges with Vaginal and Oral PrEP Use: A longitudinal qualitative study from a crossover trial in South Africa, Uganda, and Zimbabwe

This article from AIDS and Behavior explores South African, Ugandan, and Zimbabwean adolescent girls and young women’s experiences in a crossover trial of two HIV prevention products: daily oral PrEP and a monthly dapivirine vaginal ring.