Module 5
Monitoring and Evaluation
October 2018
Module 5: Monitoring and evaluation. This module is for people responsible for monitoring PrEP programmes at the national and site levels. It provides information on how to monitor
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PrEP for safety and effectiveness, suggesting core and additional indicators for site-level, national and global reporting.
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Evidence shows that oral pre-exposure prophylaxis (PrEP) reduces the risk of contracting HIV during sexual intercourse by more than 90% when taken daily. It is for this reason the National HIV Prevention Strategy 2015-2020 (2018 Revision) emphasi
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ses the role of preexposure prophylaxis (PrEP) in reducing new HIV infections in Malawi.
The Ministry of Health has prioritised PrEP use among the populations most at-risk of HIV infection in Malawi: young women ages 10 to 24 years, sero-discordant couples, female sex workers, men who have sex with men, and other priority populations (such as members of the uniformed services, prisoners, and mobile populations).
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Module 1
Clinical
July 2017
Module 1: Clinical. This module is for clinicians, including physicians, nurses and clinical officers. It gives an overview of how to provide PrEP safely and effectively, including: screening for substantial risk
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of HIV; performing appropriate testing before initiating someone on PrEP and while the person is taking PrEP; and how to follow up PrEP users and offer counselling on issues such as adherence.
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Adolescent girls and young women (AGYW) remain disproportionately affected by HIV in Eastern and Southern Africa (ESA), with 26 per cent of new infections attributed to this population. AGYW face many personal, social and structural barriers to access, uptake and use of traditional HIV prevention me
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thods. Oral Pre-exposure Prophylaxis (PrEP) is proven to be highly effective as an additional prevention choice for reducing the risk of HIV acquisition, including for AGYW. Successful uptake and adherence to PrEP is critical in its effectiveness as an HIV prevention method, however, the current demand for PrEP by AGYW is low with suboptimal adherence.
Within the ESA region, there is currently great impetus to address these challenges and scale up PrEP for AGYW. A critical aspect of this is to leverage the learnings and evidence from implementation of how to improve the demand and quality of PrEP programming for this population. Improving the Quality of Pre-Exposure Prophylaxis Implementation for Adolescent Girls and Young Women in Eastern and Southern Africa examines the current efforts in the region to accelerate and scale up evidence-based PrEP delivery platforms. The implementation brief provides current knowledge and builds on WHO guidance to provide key considerations for implementation, including driving demand and improving quality, as well as focus on wider combination prevention and integration agendas.
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Módulo 1
Clínico
Julho de 2017
Módulo 1: Clínico. Este módulo é destinado a profissionais de saúde como médicos, enfermeiros e auxiliares e traz um resumo sobre como prover a PrEP de forma segura e efetiva, abordando vários aspectos
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: triagem de pessoas com risco substancial de contrair o HIV;
ódulo 1: Clínico. Este módulo é destinado a profissionais de saúde como médicos, enfermeiros e auxiliares e traz um resumo sobre como prover a PrEP de forma segura e efetiva, abordando vários aspectos: triagem de pessoas com risco substancial de contrair o HIV; testagem de HIV antes de iniciar a PrEP e como acompanhar usuários de PrEP e oferecer aconselhamento sobre adesão.
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Módulo 2
Educadores y Defensores Comunitarios
Julio del 2017
Módulo 2: Educadores y defensores comunitarios. Para que los servicios de PrEP lleguen a los grupos poblacionales de manera efectiva y aceptable, se necesitan educadores y defe
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nsores comunitarios para aumentar la concientización acerca de la PrEP en sus comunidades. En este módulo se brinda información actualizada sobre la PrEP que debe considerarse al realizar actividades lideradas por la comunidad cuyo objetivo sea aumentar los conocimientos sobre la PrEP, promover la demanda de la PrEP y aumentar el acceso a la misma.
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WHO recommends that pre-exposure prophylaxis (PrEP) be offered as an additional prevention choice for HIV-negative individuals at substantial risk of HIV infection as part of combination prevention approaches.
HIV drug resistance has been rarely
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reported among PrEP users who tested HIV positive in randomized controlled trials or open-label studies. However, PrEP-selected HIV drug resistance could potentially negatively impact the effectiveness of treatment options among PrEP users who acquire HIV, since there is a potential for overlapping resistance profiles between antiretroviral drugs used for both PrEP and first-line antiretroviral therapy.
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Module 3
Counsellors
July 2017
Module 3: Counsellors. This module is for staff who counsel people as they consider PrEP or start taking PrEP and support them in coping with side-effects and a
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dherence strategies. Those who counsel PrEP users may be lay, peer or professional counsellors and healthcare workers, including nurses, clinical officers and doctors.
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Module 2
Community Educators and Advocates
July 2017
Module 2: Community educators and advocates. Community educators and advocates are needed to increase awareness about PrEP in their communities. This module provides information on
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PrEP that should be considered in community-led activities that aim to increase knowledge about PrEP and generate demand and access.
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Module 12:
Adolescents and young adults
July 2018
Module 12: Adolescents and young adults. This module is for people who are interested in providing PrEP services to older adolescents and young adults who are at substantial risk for HIV. It
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provides information on: factors that influence HIV susceptibility among young people; clinical considerations for safety and continuation on PrEP; ways to improve access and service utilization; and inclusive monitoring approaches to improve the recording and reporting of data on young people.
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Módulo 12
Adolescentes y Adultos de Jóvenes
Julio del 2018
Módulo 4
Líderes
Julio del 2017
Módulo 4: Líderes. Este módulo tiene por objeto informar y actualizar a los líderes y a los encargados de tomar decisiones sobre la PrEP. Proporciona información sobre los beneficios y las limitaciones d
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e la PrEP para que puedan considerar cómo pueden aplicar la PrEP de manera más efectiva en sus propios entornos. También presenta una serie de preguntas frecuentes acerca de la PrEP y las respuestas correspondientes.
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Módulo 9
Planificación estratégica
Julio del 2017
Módulo 9: Planificación estratégica. La OMS recomienda ofrecer la PrEP a las personas con un riesgo significativo de contraer la infección por el VIH, por lo que este módulo ofrece ori
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entación de salud pública para los encargados de tomar decisiones sobre cómo priorizar los servicios, con el fin de llegar a quienes se pueden beneficiar más de la PrEP, y sobre los entornos donde los servicios de PrEP podrían ser más costo-efectivos.
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This briefing paper provides an overview of pre-exposure prophylaxis (PrEP) for people planning, commissioning or providing HIV prevention activities in the UK. It does this by reviewing thirty key questions about
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PrEP and how it might be implemented in the UK.
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Module 4
Leaders
July 2017
Module 4: Leaders. This module aims to inform and update leaders and decision-makers about PrEP. It provides information on the benefits and limitations of PrEP so
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that they can consider how PrEP could be effectively implemented in their own settings. It also contains a series of frequently asked questions about PrEP.
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Module 9
Strategic planning
July 2017
Module 9: Strategic planning. As WHO recommends offering PrEP to people at substantial HIV risk, this module offers public health guidance for policy-makers on how to prioritize services, in order to reac
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h those who could benefit most from PrEP, and in which settings PrEP services could be most cost-effective.
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