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Fabrication of Pulsatile Polymeric Microparticles Encapsulating Rabies Antigen
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Implementation science of pre-exposure prophylaxis: preparing for public use.

Kristen Underhill1, Don Operario, Matthew J Mimiaga

  • 1Department of Community Health, Brown University, Providence, RI 02912, USA. kristen_underhill@brown.edu

Current HIV/AIDS Reports
|September 8, 2010
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Summary

Planning for pre-exposure prophylaxis (PrEP) implementation for HIV prevention requires integrating biomedical and behavioral strategies. Lessons learned from PrEP planning can advance the scale-up of future combination HIV interventions.

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Area of Science:

  • Public Health
  • HIV Prevention Science
  • Implementation Science

Background:

  • Antiretroviral pre-exposure prophylaxis (PrEP) efficacy trials are ongoing, prompting anticipation of implementation challenges for HIV prevention.
  • There is a growing trend towards combination interventions for HIV prevention, integrating biomedical, behavioral, and structural components.

Purpose of the Study:

  • To review the literature on PrEP implementation to identify challenges and opportunities.
  • To inform the optimal implementation of PrEP as a combination intervention for HIV prevention.
  • To advance the science of implementation and delivery for scaling up HIV prevention strategies.

Main Methods:

  • A comprehensive review of published and unpublished literature on PrEP implementation was conducted.
  • Themes were organized into five categories: scientific, regulatory/policy, stakeholder/infrastructure groundwork, delivery, and long-term monitoring.

Main Results:

  • Effective PrEP implementation necessitates integrating PrEP drugs with HIV testing, safety screening, adherence support, risk behavior interventions, and long-term monitoring.
  • Planning for PrEP implementation offers a valuable opportunity to refine combination intervention scale-up strategies.
  • Lessons from PrEP planning are transferable to future combination HIV prevention efforts.

Conclusions:

  • Optimal PrEP implementation exemplifies a combination model for HIV prevention.
  • The review highlights key areas for planning and groundwork necessary for successful PrEP rollout.
  • Findings can guide the scale-up of future integrated HIV prevention interventions.