Thank you for your interest in CCO content. As a guest, please complete the following information fields. These data help ensure our continued delivery of impactful education.
Become a member (or login)? Member benefits include accreditation certificates, downloadable slides, and decision support tools.
Head, Sexual Reproductive Adolescent Child Health Research Program
Centre for Clinical Research
Kenya Medical Research Institute (KEMRI)
Nelly Mugo, MBChB, MMed, MPH, has no relevant conflicts of interest to report.
Pre-exposure prophylaxis (PrEP) for HIV prevention has contributed to reductions in HIV infections among men who have sex with men in North America, Europe, and Australia. However, PrEP is underutilized in other geographic areas, including Africa. Worldwide, PrEP Watch estimates that approximately 1.3 million people have used PrEP between 2016 and 2019—far below the 2020 UNAIDS target of 3 million people receiving PrEP. At IDWeek 2021, data assessing gaps in delivery and evaluation of strategies to improve uptake of HIV PrEP were presented. I believe these data and strategies can be easily replicated across Africa and the rest of the globe to help us improve on PrEP delivery and uptake.
The community engagement process for recruitment of participants to the phase III lenacapavir PURPOSE 2 trial, which assessed biannual SC injections for HIV PrEP, had goals to achieve inclusivity and diversity in the participant population. Prespecified distribution of participants included populations historically underrepresented in HIV prevention research, such as Black and Hispanic/Latinx gay, bisexual, and other men who have sex with men; transgender women and men; and gender nonbinary individuals. This was achieved through a weekly metrics review during enrollment and representation of diverse populations in study teams. This study is a good reminder that equity in health can be achieved only if it is purposefully planned and implemented.
Gaps in PrEP Delivery and Uptake
Data from studies evaluating gaps in PrEP delivery and uptake across diverse populations in the United States also were presented during IDWeek 2021.
Each of these studies highlights potential opportunities and strategies for increasing PrEP delivery and uptake, and these learnings could be used by HCPs in Africa to implement in their practices.
My Key Takeaways
Consistently across populations, provider knowledge on PrEP administration was demonstrated to be low. One study that used an education campaign demonstrated doubling in PrEP initiation. We have safe and effective medications for PrEP, and we need to implement strategies like those examined here to improve provider knowledge so that more patients who qualify for PrEP are offered and prescribed it. This is of particular importance on the African continent to improve the frequency of PrEP prescribing.
What do you think is the biggest barrier that prevents providers from prescribing PrEP? Join the discussion by posting a comment. For more details on this and other key HIV issues from IDWeek 2021, review more CCO Conference Coverage, including Capsule summary slidesets, video recaps with expert faculty, and other ClinicalThought commentaries highlighting US and global perspectives.