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Open Access 01-04-2019 | Human Immunodeficiency Virus | The Science of Prevention (JD Stekler and JM Baeten, Section Editors)

Scaling-up PrEP Delivery in Sub-Saharan Africa: What Can We Learn from the Scale-up of ART?

Authors: Gabrielle O’Malley, Gena Barnabee, Kenneth Mugwanya

Published in: Current HIV/AIDS Reports | Issue 2/2019

Abstract

Purpose of Review

Clinical trials have found that PrEP is highly effective in reducing risk of HIV acquisition across types of exposure, gender, PrEP regimens, and dosing schemes. Evidence is urgently needed to inform scale-up of PrEP to meet the ambitious WHO/UNAIDS prevention target of 3,000,000 individuals on PrEP by 2020.

Recent Findings

Successful models of delivering HIV services at scale evolved from years of formal research and programmatic evidence. These efforts produced lessons-learned relevant for scaling-up PrEP delivery, including the importance of streamlining laboratory tests, expanding prescription and management authority, differentiating medication access points, and reducing stigma and barriers of parental consent for PrEP uptake. Further research is especially needed in areas differentiating PrEP from ART delivery, including repeat HIV testing to ensure HIV negative status and defining and measuring prevention-effective adherence.

Summary

Evidence from 15 years of ART scale-up could immediately inform a public health approach to PrEP delivery.

Fauci AS, Eisinger RW. PEPFAR — 15 Years and Counting the Lives Saved. N Engl J Med. 2018;378(4):314–6. https://doi.org/10.1056/NEJMp1714773.CrossRefPubMed

Bendavid E. Past and Future Performance: PEPFAR in the Landscape of Foreign Aid for Health. Current HIV/AIDS reports. 2016;13(5):256–62. https://doi.org/10.1007/s11904-016-0326-8.CrossRefPubMedPubMedCentral

Weller I. Delivery of Antiretroviral Therapy in Sub-Saharan Africa. Clin Infect Dis. 2006, 43(6):777–8. https://doi.org/10.1086/507113.

Baggaley R, Hensen B, Ajose O, Grabbe KL, Wong VJ, Schilsky A, et al. From caution to urgency: the evolution of HIV testing and counselling in Africa. Bull World Health Organ. 2012;90(9):652–8b. https://doi.org/10.2471/blt.11.100818.CrossRefPubMedPubMedCentral

McCoy D, Chopra M, Loewenson R, Aitken J-M, Ngulube T, Muula A, et al. Expanding Access to Antiretroviral Therapy in Sub-Saharan Africa: Avoiding the Pitfalls and Dangers, Capitalizing on the Opportunities. Am J Public Health. 2005;95(1):18–22. https://doi.org/10.2105/AJPH.2004.040121.CrossRefPubMedPubMedCentral

Creese A, Floyd K, Alban A, Guinness L. Cost-effectiveness of HIV/AIDS interventions in Africa: a systematic review of the evidence. Lancet. 2002;359(9318):1635–42. https://doi.org/10.1016/S0140-6736(02)08595-1.CrossRefPubMed

UNAIDS. Towards Universal Acess: Scaling up Priority HIV/AIDS Interventions in the Health Sector. UNAIDS. 2009. http://data.unaids.org/pub/report/2009/20090930_tuapr_2009_en.pdf. Accessed 5 June 2018.

The treatment 2.0 framework for action: catalysing the next phase of treatment, care and support. 2011. http://apps.who.int/iris/bitstream/handle/10665/44640/9789241501934_eng.pdf;jsessionid=A3D92348E6F0A91B9FD63D78778BB050?sequence=1. Accessed May 20 2018.

Ford N, Calmy A, Mills EJ. The first decade of antiretroviral therapy in Africa. Glob Health. 2011;7(1):33. https://doi.org/10.1186/1744-8603-7-33.CrossRef

10.

Harries AD, Ford N, Jahn A, Schouten EJ, Libamba E, Chimbwandira F, et al. Act local, think global: how the Malawi experience of scaling up antiretroviral treatment has informed global policy. BMC Public Health. 2016;16(1):938. https://doi.org/10.1186/s12889-016-3620-x.CrossRefPubMedPubMedCentral

11.

UNAIDS. AIDSinfo. http://aidsinfo.unaids.org/?did=5757e25b2d8e328007747ce1&r=world-continents&t=null&tb=d&bt=drli&ts=&tr=world-continents&aid=5ae0712562abc329969a8de0&sav=Population:%20All%20ages&tl=1

12.

Bendavid E, Bhattacharya J. PEPFAR in Africa: An Evaluation of Outcomes. Ann Intern Med. 2009;150(10):688–95 http://annals.org/aim/fullarticle/744499/president-s-emergency-plan-aids-relief-africa-evaluation-outcomes.CrossRefPubMedPubMedCentral

13.

Eyawo O, de Walque D, Ford N, Gakii G, Lester RT, Mills EJ. HIV status in discordant couples in sub-Saharan Africa: a systematic review and meta-analysis. Lancet Infect Dis. 2010;10(11):770–7. https://doi.org/10.1016/s1473-3099(10)70189-4.CrossRefPubMed

14.

UNAIDS. 90–90-90 an Ambitious Treatment Target to Help End the AIDS Epidemic. Geneva2014 October. Report No.: JC2684.

15.

World Health Organization. Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. WHO, Geneva. 2015. http://apps.who.int/iris/bitstream/10665/186275/1/9789241509565_eng.pdf. Accessed December 30 2017.

16.

Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99. https://doi.org/10.1056/NEJMoa1011205.CrossRefPubMedPubMedCentral

17.

Baeten JM, Donnell D, Ndase P, Mugo NR, Campbell JD, Wangisi J, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367(5):399–410. https://doi.org/10.1056/NEJMoa1108524.CrossRefPubMedPubMedCentral

18.

Fonner VA, Dalglish SL, Kennedy CE, Baggaley R, O'Reilly KR, Koechlin FM, et al. Effectiveness and safety of oral HIV preexposure prophylaxis for all populations. AIDS. 2016;30(12):1973–83. https://doi.org/10.1097/qad.0000000000001145.CrossRefPubMed

19.

Cowan FM, Delany-Moretlwe S, Sanders EJ, Mugo NR, Guedou FA, Alary M, et al. PrEP implementation research in Africa: what is new? J Int AIDS Soc. 2016;19(7(Suppl 6)):21101. https://doi.org/10.7448/ias.19.7.21101.CrossRefPubMedPubMedCentral

20.

Celum CL D-DM, McConnell M, , van Rooyen H, Bekker LG, Kurth A, Bukusi E, Desmond C, Morton J, Baeten JM. Rethinking HIV prevention to prepare for oral PrEP implementation for young African women. Journal of the International AIDS Society 2015:18(4Suppl3):20227. Doi: doi:https://doi.org/10.7448/IAS.18.4.20227.

21.

Baeten JM. Amplifying the Population Health Benefits of PrEP for HIV Prevention. J Infect Dis. 2018;217(10):1509–11. https://doi.org/10.1093/infdis/jiy045.CrossRefPubMedPubMedCentral

22.

Marcus JL, Volk JE, Pinder J, Liu AY, Bacon O, Hare CB, et al. Successful Implementation of HIV Preexposure Prophylaxis: Lessons Learned From Three Clinical Settings. Current HIV/AIDS reports. 2016;13(2):116–24. https://doi.org/10.1007/s11904-016-0308-x.CrossRefPubMed

23.

Ongoing and Planned PrEP Demonstration and Implementation Studies. In: Fact Sheet. AVAC. 2017. https://www.avac.org/resource/ongoing-and-planned-prep-demonstration-and-implementation-studies. Accessed 23 June 2018.

24.

Selke HM, Kimaiyo S, Sidle JE, Vedanthan R, Tierney WM, Shen C, et al. Task-shifting of antiretroviral delivery from health care workers to persons living with HIV/AIDS: clinical outcomes of a community-based program in Kenya. J Acquir Immune Defic Syndr. 2010;55(4):483–90. https://doi.org/10.1097/QAI.0b013e3181eb5edb.CrossRefPubMed

25.

•• Chambers DA, Norton WE. The Adaptome: Advancing the Science of Intervention Adaptation. Am J Prev Med. 2016;51(4 Suppl 2):S124–31. https://doi.org/10.1016/j.amepre.2016.05.011 This article provides a thorough discussion of the limitations of the linear pathway from efficacy trials to scaled implementation in diverse settings. It compellingly describes the dynamic role of adaptation and practice-based evidence in increasing the effectiveness of evidenced based intervention as they move to delivery settings. CrossRefPubMedPubMedCentral

26.

Glasgow RE, Lichtenstein E, Marcus AC. Why don't we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. Am J Public Health. 2003;93(8):1261–7.CrossRefPubMedPubMedCentral

27.

Paina L, Peters DH. Understanding pathways for scaling up health services through the lens of complex adaptive systems. Health Policy Plan. 2012;27(5):365–73. https://doi.org/10.1093/heapol/czr054.CrossRefPubMed

28.

Castro FG, Barrera M Jr, Martinez CR Jr. The cultural adaptation of prevention interventions: resolving tensions between fidelity and fit. Prev Sci. 2004;5(1):41–5.CrossRefPubMed

29.

Brainard J, Hunter PR. Do complexity-informed health interventions work? A scoping review. Implement Sci. 2016;11(1):127. https://doi.org/10.1186/s13012-016-0492-5.CrossRefPubMedPubMedCentral

30.

Katzenstein D, Koulla-Shiro S, Laga M, Moatti JP. Learning and doing: operational research and access to HIV treatment in Africa. Aids. 2010;24(Suppl 1):S1–4. https://doi.org/10.1097/01.aids.0000366077.37827.0a.CrossRefPubMed

31.

Ilott I, Gerrish K, Pownall S, Eltringham S, Booth A. Exploring scale-up, spread, and sustainability: an instrumental case study tracing an innovation to enhance dysphagia care. Implement Sci. 2013;8:128. https://doi.org/10.1186/1748-5908-8-128.CrossRefPubMedPubMedCentral

32.

Gavetti G, Rivkin J. How Strategists Really Think: Tapping the Power of Analogy. Harvard Business Review 2005:April. https://hbr.org/2005/04/how-strategists-really-think-tapping-the-power-of-analogy.

33.

Leuzzi F, Ferilli S. A multi-strategy approach to structural analogy making. J Intell Inf Syst. 2018;50(1). https://doi.org/10.1007/s10844-017-0447-6.

34.

Schauer† F, Spellman B. Analogy, Expertise, and Experience. The University of Chicago Law Review 2017:84(1).

35.

Gentner D, Brem S, Ferguson RW, Markman AB, Levidow BB, Wolff P, et al. Analogical Reasoning and Conceptual Change : A Case Study of Johannes Kepler. J Learn Sci. 1997;g(1):3–40. https://doi.org/10.1207/s15327809jls0601_2.CrossRef

36.

Hoyos C, Gentner D. Generating explanations via analogical comparison. Psychon Bull Rev. 2017;24(5):1364–74. https://doi.org/10.3758/s13423-017-1289-5.CrossRefPubMed

37.

Golub SA, Operario D, Gorbach PM. Pre-exposure prophylaxis state of the science: empirical analogies for research and implementation. Current HIV/AIDS reports. 2010;7(4):201–9. https://doi.org/10.1007/s11904-010-0057-1.CrossRefPubMedPubMedCentral

38.

Asboe D, Aitken C, Boffito M, Booth C, Cane P, Fakoya A, et al. British HIV Association guidelines for the routine investigation and monitoring of adult HIV-1-infected individuals 2011. HIV Med. 2012;13(1):1–44. https://doi.org/10.1111/j.1468-1293.2011.00971.x.CrossRefPubMed

39.

World Health Organization. Scaling up antiretroviral therapy in resource-limited settings : guidelines for a public health approach. 2003. http://www.who.int/hiv/pub/prev_care/ScalingUp_E.pdf. Accessed 5 June 2018.

40.

World Health Organization. Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection: Recommendations for a Public Health Approach. Geneva. 2016. http://apps.who.int/iris/bitstream/handle/10665/208825/9789241549684_eng.pdf;jsessionid=E12EB5C4DF198A9389F34DBAE12676E3?sequence=1. Accessed 13 June 2018.

41.

Team DT, Mugyenyi P, Walker AS, Hakim J, Munderi P, Gibb DM, et al. Routine versus clinically driven laboratory monitoring of HIV antiretroviral therapy in Africa (DART): a randomised non-inferiority trial. Lancet. 2010;375(9709):123–31. https://doi.org/10.1016/S0140-6736(09)62067-5.CrossRef

42.

Fox K, Ferguson J, Ajose W, Singh J, Marum E, Baggaley R. Adolescent consent to testing: a review of current policies and issues in sub-Saharan Africa. HIV and Adolescents: Guidance for HIV Testing and Counselling and Care for Adolescents Living with HIV: Recommendations for a Public Health Approach and Considerations for Policy-Makers and Managers. Geneva: World Health Organization; 2013.

43.

Mugwanya KK, John-Stewart G, Baeten J. Safety of oral tenofovir disoproxil fumarate-based HIV pre-exposure prophylaxis use in lactating HIV-uninfected women. Expert Opin Drug Saf. 2017;16(7):867–71. https://doi.org/10.1080/14740338.2017.1338271.CrossRefPubMedPubMedCentral

44.

Mugwanya KK, Wyatt C, Celum C, Donnell D, Mugo NR, Tappero J, et al. Changes in glomerular kidney function among HIV-1-uninfected men and women receiving emtricitabine-tenofovir disoproxil fumarate preexposure prophylaxis: a randomized clinical trial. JAMA Intern Med. 2015;175(2):246–54. https://doi.org/10.1001/jamainternmed.2014.6786.CrossRefPubMedPubMedCentral

45.

Mugwanya KK, Wyatt C, Celum C, Donnell D, Kiarie J, Ronald A, et al. Reversibility of Glomerular Renal Function Decline in HIV-Uninfected Men and Women Discontinuing Emtricitabine-Tenofovir Disoproxil Fumarate Pre-Exposure Prophylaxis. J Acquir Immune Defic Syndr. 2016;71(4):374–80. https://doi.org/10.1097/qai.0000000000000868.CrossRefPubMedPubMedCentral

46.

Mulligan K, Glidden DV, Anderson PL, Liu A, McMahan V, Gonzales P, et al. Effects of Emtricitabine/Tenofovir on Bone Mineral Density in HIV-Negative Persons in a Randomized, Double-Blind, Placebo-Controlled Trial. Clin Infect Dis. 2015;61(4):572–80. https://doi.org/10.1093/cid/civ324.CrossRefPubMedPubMedCentral

47.

http://emtct-iatt.org/wp-content/uploads/2016/09/Guidelines-on-Use-of-Antiretroviral-Drugs-for-Treating-and-Preventing-HI....pdf. Guidelines on the use of antiretroviral drugs for treating and preventing HIV infection in Kenya.

48.

Callaghan M, Ford N, Schneider H. A systematic review of task- shifting for HIV treatment and care in Africa. Hum Resour Health. 2010;8:8. https://doi.org/10.1186/1478-4491-8-8.CrossRefPubMedPubMedCentral

49.

Sanne I, Orrell C, Fox MP, Conradie F, Ive P, Zeinecker J, et al. Nurse versus doctor management of HIV-infected patients receiving antiretroviral therapy (CIPRA-SA): a randomised non-inferiority trial. Lancet. 2010;376(9734):33–40. https://doi.org/10.1016/s0140-6736(10)60894-x.CrossRefPubMedPubMedCentral

50.

Asfaw E, Dominis S, Palen JG, Wong W, Bekele A, Kebede A, et al. Patient satisfaction with task shifting of antiretroviral services in Ethiopia: implications for universal health coverage. Health Policy Plan. 2014;29(Suppl 2):ii50–8. https://doi.org/10.1093/heapol/czu072.CrossRefPubMedPubMedCentral

51.

Suzan-Monti M, Blanche J, Boyer S, Kouanfack C, Delaporte E, Bonono RC, et al. Benefits of task-shifting HIV care to nurses in terms of health-related quality of life in patients initiating antiretroviral therapy in rural district hospitals in Cameroon [Stratall Agence Nationale de Recherche sur le SIDA (ANRS) 12110/Ensemble pour une Solidarite Therapeutique Hospitaliere en Reseau (ESTHER) substudy]. HIV Med. 2015;16(5):307–18. https://doi.org/10.1111/hiv.12213.CrossRefPubMed

52.

Mugwanya KK, Baeten JM. Safety of oral tenofovir disoproxil fumarate-based pre-exposure prophylaxis for HIV prevention. Expert Opin Drug Saf. 2016;15(2):265–73. https://doi.org/10.1517/14740338.2016.1128412.CrossRefPubMed

53.

Heffron R, Pintye J, Matthews LT, Weber S, Mugo N. PrEP as peri-conception HIV prevention for women and men. Current HIV/AIDS reports. 2016;13(3):131–9. https://doi.org/10.1007/s11904-016-0312-1.CrossRefPubMedPubMedCentral

54.

Duncombe C, Rosenblum S, Hellmann N, Holmes C, Wilkinson L, Biot M, et al. Reframing HIV care: putting people at the centre of antiretroviral delivery. Tropical Med Int Health. 2015;20(4):430–47. https://doi.org/10.1111/tmi.12460.CrossRef

55.

• Grimsrud A, Bygrave H, Doherty M, Ehrenkranz P, Ellman T, Ferris R, et al. Reimagining HIV service delivery: the role of differentiated care from prevention to suppression. J Int AIDS Soc. 2016;19(1):21484. https://doi.org/10.7448/IAS.19.1.21484 This article summarizes evidence for differentiated models of ART service delivery and how this will be crucial for achieving epidemic control. Evidence of what is needed to scale is applicable to PrEP, which is a much safer regimen than ART. CrossRefPubMedPubMedCentral

56.

Médecins Sans Frontières. Reaching closer to home: Progress implementing community-based and other adherence strategies supporting people on HIV treatment, 2013. https://www.msf.org/sites/msf.org/files/reaching_closer_to_home.pdf.

57.

Prust ML, Banda CK, Nyirenda R, Chimbwandira F, Kalua T, Jahn A, et al. Multi-month prescriptions, fast-track refills, and community ART groups: results from a process evaluation in Malawi on using differentiated models of care to achieve national HIV treatment goals. J Int AIDS Soc. 2017;20(Suppl 4):21650. https://doi.org/10.7448/IAS.20.5.21650.CrossRefPubMedPubMedCentral

58.

Mody A, Roy M, Sikombe K, Savory T, Holmes C, Bolton-Moore C, et al. Improved Retention With 6-Month Clinic Return Intervals for Stable Human Immunodeficiency Virus-Infected Patients in Zambia. Clin Infect Dis. 2018;66(2):237–43. https://doi.org/10.1093/cid/cix756.CrossRefPubMed

59.

Mbonye M, Seeley J, Ssembajja F, Birungi J, Jaffar S. Adherence to antiretroviral therapy in Jinja, Uganda: a six-year follow-up study. PLoS One. 2013;8(10):e78243. https://doi.org/10.1371/journal.pone.0078243.CrossRefPubMedPubMedCentral

60.

Okoboi S, Ding E, Persuad S, Wangisi J, Birungi J, Shurgold S, et al. Community-based ART distribution system can effectively facilitate long-term program retention and low-rates of death and virologic failure in rural Uganda. AIDS Res Ther. 2015;12:37. https://doi.org/10.1186/s12981-015-0077-4.CrossRefPubMedPubMedCentral

61.

Wood EM, Zani B, Esterhuizen TM, Young T. Nurse led home-based care for people with HIV/AIDS. BMC Health Serv Res. 2018;18(1):219. https://doi.org/10.1186/s12913-018-3002-4.CrossRefPubMedPubMedCentral

62.

Tsondai PR, Wilkinson LS, Grimsrud A, Mdlalo PT, Ullauri A, Boulle A. High rates of retention and viral suppression in the scale-up of antiretroviral therapy adherence clubs in Cape Town, South Africa. J Int AIDS Soc. 2017;20(Suppl 4):21649. https://doi.org/10.7448/IAS.20.5.21649.CrossRefPubMedPubMedCentral

63.

Khabala KB, Edwards JK, Baruani B, Sirengo M, Musembi P, Kosgei RJ, et al. Medication Adherence Clubs: a potential solution to managing large numbers of stable patients with multiple chronic diseases in informal settlements. Tropical Med Int Health. 2015;20(10):1265–70. https://doi.org/10.1111/tmi.12539.CrossRef

64.

Decroo T, Rasschaert F, Telfer B, Remartinez D, Laga M, Ford N. Community-based antiretroviral therapy programs can overcome barriers to retention of patients and decongest health services in sub-Saharan Africa: a systematic review. Int Health. 2013;5(3):169–79. https://doi.org/10.1093/inthealth/iht016.CrossRefPubMed

65.

Boyer S, Protopopescu C, Marcellin F, Carrieri MP, Koulla-Shiro S, Moatti JP, et al. Performance of HIV care decentralization from the patient's perspective: health-related quality of life and perceived quality of services in Cameroon. Health Policy Plan. 2012;27(4):301–15. https://doi.org/10.1093/heapol/czr039.CrossRefPubMed

66.

Mwai GW, Mburu G, Torpey K, Frost P, Ford N, Seeley J. Role and outcomes of community health workers in HIV care in sub-Saharan Africa: a systematic review. J Int AIDS Soc. 2013;16:18586. https://doi.org/10.7448/IAS.16.1.18586.CrossRefPubMedPubMedCentral

67.

Grimsrud A, Lesosky M, Kalombo C, Bekker LG, Myer L. Implementation and Operational Research: Community-Based Adherence Clubs for the Management of Stable Antiretroviral Therapy Patients in Cape Town, South Africa: A Cohort Study. J Acquir Immune Defic Syndr. 2016;71(1):e16–23. https://doi.org/10.1097/QAI.0000000000000863.CrossRefPubMed

68.

Nachega JB, Adetokunboh O, Uthman OA, Knowlton AW, Altice FL, Schechter M, et al. Community-Based Interventions to Improve and Sustain Antiretroviral Therapy Adherence, Retention in HIV Care and Clinical Outcomes in Low- and Middle-Income Countries for Achieving the UNAIDS 90–90-90 Targets. Current HIV/AIDS reports. 2016;13(5):241–55. https://doi.org/10.1007/s11904-016-0325-9.CrossRefPubMedPubMedCentral

69.

Tung EL, Thomas A, Eichner A, Shalit P. Implementation of a community pharmacy-based pre-exposure prophylaxis service: a novel model for pre-exposure prophylaxis care. Sex Health. 2018;15(6):556–61. https://doi.org/10.1071/sh18084.CrossRefPubMed

70.

Stekler JD, McMahan V, Ballinger L, Viquez L, Swanson F, Stockton J, et al. HIV Pre-exposure Prophylaxis Prescribing Through Telehealth. J Acquir Immune Defic Syndr. 2018;77(5):e40–e2. https://doi.org/10.1097/qai.0000000000001621.CrossRefPubMed

71.

Guanira JV, Leigler T, Kallas E, Schechter M, Sharma U, Glidden D, et al. Streamlining HIV Testing for HIV Preexposure Prophylaxis. J Clin Microbiol. 2015;53(1):179–83. https://doi.org/10.1128/JCM.01540-14.CrossRefPubMed

72.

Estem KS, Catania J, Klausner JD. HIV Self-Testing: a Review of Current Implementation and Fidelity. Current HIV/AIDS reports. 2016;13(2):107–15. https://doi.org/10.1007/s11904-016-0307-y.CrossRefPubMed

73.

De Luca A, Zazzi M. Interplay Between Transmitted and Acquired HIV Type 1 Drug Resistance: Reasons for a Disconnect. J Infect Dis. 2015;212(1):5–7. https://doi.org/10.1093/infdis/jiv008.CrossRefPubMedPubMedCentral

74.

Horizons Population Council ICfRHaCPGH. Adherence to Antiretroviral Therapy Iin Adults: A Guide for Trainers. Mobassa, Kenya. 2004. https://www.popcouncil.org/uploads/pdfs/horizons/arvadhrnctrngguide.pdf. Accessed 25 May 2018.

75.

The United Republic of Tanzania Ministry of Health and Social Welfare National AIDS Control Programme. National Standard Operating Procedures for HIV Care and Treatment. 2013. http://ihi.eprints.org/1238/1/Adherence_Counselling_for_HIV_Care_and_Treatment_Module_5_march_2013.pdf. Accessed 15 May 2018.

76.

Rosen S, Fox MP. Retention in HIV Care between Testing and Treatment in Sub-Saharan Africa: A Systematic Review. PLoS Med. 2011;8(7):e1001056. https://doi.org/10.1371/journal.pmed.1001056.CrossRefPubMedPubMedCentral

77.

Haberer JE, Sabin L, Amico KR, Orrell C, Galarraga O, Tsai AC, et al. Improving antiretroviral therapy adherence in resource-limited settings at scale: a discussion of interventions and recommendations. J Int AIDS Soc. 2017;20(1):21371. https://doi.org/10.7448/ias.20.1.21371.CrossRefPubMedPubMedCentral

78.

Liegler T, Abdel-Mohsen M, Bentley LG, Atchison R, Schmidt T, Javier J, et al. HIV-1 drug resistance in the iPrEx preexposure prophylaxis trial. J Infect Dis. 2014;210(8):1217–27. https://doi.org/10.1093/infdis/jiu233.CrossRefPubMedPubMedCentral

79.

Lehman DA, Baeten JM, McCoy CO, Weis JF, Peterson D, Mbara G, et al. Risk of drug resistance among persons acquiring HIV within a randomized clinical trial of single- or dual-agent preexposure prophylaxis. J Infect Dis. 2015;211(8):1211–8. https://doi.org/10.1093/infdis/jiu677.CrossRefPubMedPubMedCentral

80.

Weis JF, Baeten JM, McCoy CO, Warth C, Donnell D, Thomas KK, et al. Preexposure prophylaxis-selected drug resistance decays rapidly after drug cessation. Aids. 2016;30(1):31–5. https://doi.org/10.1097/qad.0000000000000915.CrossRefPubMed

81.

Grant RM, Liegler T, Defechereux P, Kashuba AD, Taylor D, Abdel-Mohsen M, et al. Drug resistance and plasma viral RNA level after ineffective use of oral pre-exposure prophylaxis in women. Aids. 2015;29(3):331–7. https://doi.org/10.1097/qad.0000000000000556.CrossRefPubMed

82.

Haberer JE, Bangsberg DR, Baeten JM, Curran K, Koechlin F, Amico KR, et al. Defining success with HIV pre-exposure prophylaxis: a prevention-effective adherence paradigm. Aids. 2015;29(11):1277–85. https://doi.org/10.1097/qad.0000000000000647.CrossRefPubMed

83.

Delany-Moretlwe S, Cowan FM, Busza J, Bolton-Moore C, Kelley K, Fairlie L. Providing comprehensive health services for young key populations: needs, barriers and gaps. J Int AIDS Soc. 2015;18(2 Suppl 1):19833. https://doi.org/10.7448/IAS.18.2.19833.CrossRefPubMedPubMedCentral

84.

Eba PM, Lim H. Reviewing independent access to HIV testing, counselling and treatment for adolescents in HIV-specific laws in sub-Saharan Africa: implications for the HIV response. J Int AIDS Soc. 2017;20(1):21456. https://doi.org/10.7448/IAS.20.1.21456.CrossRefPubMedPubMedCentral

85.

HIV and adolescents: guidance for HIV testing and counselling and care for adolescents living with HIV: recommendations for a public health approach and considerations for policy-makers and managers. Geneva: World Health Organization. 2013.

86.

Muller A, Rohrs S, Hoffman-Wanderer Y, Moult K. "You have to make a judgment call".--Morals, judgments and the provision of quality sexual and reproductive health services for adolescents in South Africa. Soc Sci Med 2016:148:71–8. https://doi.org/10.1016/j.socscimed.2015.11.048.

87.

88.

Strode A, Essack Z. Facilitating access to adolescent sexual and reproductive health services through legislative reform: Lessons from the South African experience. S Afr Med J. 2017;107(9):741–4. https://doi.org/10.7196/SAMJ.2017.v107i9.12525.CrossRefPubMed

89.

Tumlinson K, Okigbo CC, Speizer IS. Provider barriers to family planning access in urban Kenya. Contraception. 2015;92(2):143–51. https://doi.org/10.1016/j.contraception.2015.04.002.CrossRefPubMedPubMedCentral

90.

Mahajan AP, Sayles JN, Patel VA, Remien RH, Ortiz D, Szekeres G, et al. Stigma in the HIV/AIDS epidemic: A review of the literature and recommendations for the way forward. AIDS. 2008;22(Suppl 2):S67–79. https://doi.org/10.1097/01.aids.0000327438.13291.62.CrossRefPubMed

91.

Famoroti TO, Fernandes L, Chima SC. Stigmatization of people living with HIV/AIDS by healthcare workers at a tertiary hospital in KwaZulu-Natal, South Africa: a cross-sectional descriptive study. BMC Med Ethics. 2013;14(1):S6. https://doi.org/10.1186/1472-6939-14-s1-s6.CrossRefPubMedPubMedCentral

92.

wrong. From caution to urgency: the evolution of HIV testing and counselling in Africa. Bull World Health Organ 2012:90(9):652-8b. https://doi.org/10.2471/blt.11.100818.

93.

Chan BT, Tsai AC, Siedner MJ. HIV Treatment Scale-Up and HIV-Related Stigma in Sub-Saharan Africa: A Longitudinal Cross-Country Analysis. Am J Public Health. 2015;105(8):1581–7. https://doi.org/10.2105/AJPH.2015.302716.CrossRefPubMedPubMedCentral

94.

Chan BT, Tsai AC. HIV stigma trends in the general population during antiretroviral treatment expansion: analysis of 31 countries in sub-Saharan Africa, 2003–2013. J Acquir Immune Defic Syndr. 2016;72(5):558–64. https://doi.org/10.1097/qai.0000000000001011.CrossRefPubMedPubMedCentral

95.

Mack N, Odhiambo J, Wong CM, Agot K. Barriers and facilitators to pre-exposure prophylaxis (PrEP) eligibility screening and ongoing HIV testing among target populations in Bondo and Rarieda, Kenya: Results of a consultation with community stakeholders. BMC Health Serv Res 2014:14:231-. Doi: https://doi.org/10.1186/1472-6963-14-231.

96.

Peng P, Su S, Fairley CK, Chu M, Jiang S, Zhuang X, et al. A Global Estimate of the Acceptability of Pre-exposure Prophylaxis for HIV Among Men Who have Sex with Men: A Systematic Review and Meta-analysis. AIDS Behav. 2018;22(4):1063–74. https://doi.org/10.1007/s10461-017-1675-z.CrossRefPubMed

97.

Blake Helms C, Turan JM, Atkins G, Kempf MC, Clay OJ, Raper JL, et al. Interpersonal Mechanisms Contributing to the Association Between HIV-Related Internalized Stigma and Medication Adherence. AIDS Behav. 2017;21(1):238–47. https://doi.org/10.1007/s10461-016-1320-2.CrossRefPubMed

98.

• Golub SA. PrEP Stigma: Implicit and Explicit Drivers of Disparity. Current HIV/AIDS reports. 2018;15(2):190–7. https://doi.org/10.1007/s11904-018-0385-0 This review article describes how PrEP stigma directly impacts its scalability as a prevention strategy and provides approaches to mitigate stigma associated with PrEP. CrossRefPubMedPubMedCentral

99.

Calabrese SK, Underhill K. How Stigma Surrounding the Use of HIV Preexposure Prophylaxis Undermines Prevention and Pleasure: A Call to Destigmatize "Truvada Whores". Am J Public Health. 2015;105(10):1960–4. https://doi.org/10.2105/ajph.2015.302816.CrossRefPubMedPubMedCentral

Title: Scaling-up PrEP Delivery in Sub-Saharan Africa: What Can We Learn from the Scale-up of ART?
Authors: Gabrielle O’Malley
Gena Barnabee
Kenneth Mugwanya
Publication date: 01-04-2019
Publisher: Springer US
Keywords: Human Immunodeficiency Virus
Acquired Immune Deficiency Syndrome
Published in: Current HIV/AIDS Reports / Issue 2/2019
Print ISSN: 1548-3568
Electronic ISSN: 1548-3576
DOI: https://doi.org/10.1007/s11904-019-00437-6

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At a glance: The STEP trials