PrEP

Eastern and southern Africa (ESA) is the world’s most heavily HIV-impacted region, with adolescent girls and young women (AGYW) disproportionately affected. To support the scale-up of PrEP amongst AGYW in ESA, in September 2021 UNICEF and partners released the implementation brief “Improving the Quality of Pre-Exposure Prophylaxis Implementation for Adolescent Girls and Young Women in Eastern and Southern Africa,” highlighting considerations to help improve the quality and coverage of AGYW PrEP programming.

The PrEP landscape has evolved significantly in the three years since the original brief was released, both in scale and variety. This updated brief summarises the most recent evidence on AGYW PrEP provision, serving as a supplement to the original 2021 implementation brief.

This implementation brief examines the current efforts in eastern and southern Africa to accelerate and scale up evidence-based PrEP delivery platforms for adolescent girls and young women. The 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.

Adolescent girls and young women (AGYW) remain disproportionately affected by HIV in eastern and southern Africa, however, they face many personal, social and structural barriers to access, uptake and use of traditional HIV prevention methods. Oral Pre-exposure Prophylaxis (PrEP) is proven to be highly effective as an additional prevention choice for reducing the risk of HIV acquisition, but the current demand for PrEP by AGYW is low with suboptimal adherence.

Within the 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 is informed by knowledge and lessons learned emerging from a virtual thank tank and webinar convened by UNICEF together with WHO AFRO and the Global Fund, with support from the SIDA funded 2gether 4 SRHR programme, in early 2021.

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EVIDENCE UPDATE 2024

Over the past three years, the PrEP landscape has evolved significantly including for AGYW in Eastern and Southern Africa who continue to be disproportionately affected by HIV. The evidence update titled: Pre-Exposure Prophylaxis and Adolescent Girls and Young Women in Eastern and Southern Africa: The latest insights, aims to enhance the quality and coverage of PrEP programming for AGYW. The brief, developed by AVAC, UNICEF and the Global Fund, summarizes the most recent evidence on AGYW PrEP provision and serves as a supplement to the original 2021 implementation brief.

The AGYW Programming & Implementation Repository contains resources relevant to AGYW programming that have been collated to support enhanced implementation and programming of Global Fund Catalytic Funding for HIV prevention among AGYW in Eastern and Southern Africa. Developed in collaboration with Global Fund in response to an identified need from the SEA sub-region, we are confident that you will all find the repository useful in your support of national AGYW programmes.

The repository is housed on Google Drive and is accessible without a Gmail account. The resources are organized in folders by key programming area and are easily searchable through a google sheet. Powerpoint slides have also been developed to help you navigate through the repository.

The spreadsheet and slideshow are available for download above.

The International Treatment Preparedness Coalition developed the Key Population Activist Toolkit on PrEP, to equip community activists with the knowledge and skills they need to demand pre-exposure prophylaxis (PrEP).

Community-led demand efforts can influence the success of PrEP programming, including influencing how accessible PrEP services are to the community, whether people actually choose to take PrEP, and whether these services are being offered in a way that is suited to the needs of PrEP users.

The Toolkit aims to:

• Equip community activists with the knowledge and skills that they need around PrEP, advocacy, and community mobilization so that they are able to mobilize their communities to demand PrEP
• To enable community PrEP activists to advocate with their governments and service providers to allow key populations access to PrEP services
• To ensure that these services are provided in a manner that is affordable, appropriate to their needs, and addresses access barriers.

The toolkit is intended for individuals, organizations and networks – particularly those representing key populations – wanting to:

• Learn more about PrEP
• Contribute to preventing the spread of HIV in their communities
• Gain the knowledge and skills that they need to mobilize their communities and advocate with community leaders and decision makers for access to PrEP

This Population Council document primarily aims to provide DREAMS country teams with practical guidance on building evidence on PrEP for adolescent girls and young women (AGYW). It includes factors that influence informed choice, demand and use of PrEP by young women, key characteristics that affect client-provider interactions, and practical advice on gathering data on user, community, and provider perspectives.

The strategic plan focuses on preventing new HIV infections in order to maintain a low HIV prevalence in the next six years. The NSP aims to reduce new HIV infections by 50% by 2020; intensify the provision of quality and accessible HIV prevention information and services for key populations; and also accelerate actions to eliminate mother-to-child transmission of HIV by 2020, including placing positive mothers on lifelong antiretroviral therapy (Option B+) as the preferred regime of treatment for HIV positive pregnant women.

The new Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations outline a public health response for 5 key populations (men who have sex with men, trans and gender diverse people, sex workers, people who inject drugs and people in prisons and other closed settings). They present and discuss new recommendations and consolidate a range of recommendations and guidance from current WHO guidelines.