Pre-exposure prophylaxis rollout in a national public sector program: the Kenyan case study

Area of Science:

• Public Health
• Epidemiology
• HIV/AIDS Prevention

Background:

• Despite advancements in HIV treatment and prevention, new infections persist globally.
• Sub-Saharan Africa faces a significant HIV burden, making innovative prevention strategies crucial.
• Pre-exposure prophylaxis (PrEP) offers a new biomedical prevention option for individuals at high risk of HIV acquisition.

Purpose of the Study:

• To detail Kenya's experience in rolling out pre-exposure prophylaxis (PrEP) as a national public sector program.
• To outline the strategies, partnerships, challenges, and lessons learned during the national scale-up of PrEP in Kenya by 2018.
• To provide guidance for low- and middle-income countries planning similar PrEP implementation.

Main Methods:

• National PrEP rollout led by the government through a multidisciplinary, multi-organization team.
• Integration of PrEP guidance, logistics, and health information systems.
• Prioritization of 19 high-incidence counties and targeted resource allocation for maximum impact.

Main Results:

• PrEP is accessible in over 900 healthcare facilities nationwide.
• Over 14,000 individuals were using PrEP one year after program launch.
• Kenya became the first African nation to implement a public sector national PrEP program.

Conclusions:

• Kenya's public sector PrEP rollout demonstrates successful national implementation.
• The program's phased approach, focusing on high-burden areas, maximized impact and cost-effectiveness.
• This case study offers a replicable model for other nations addressing generalized and concentrated HIV epidemics.