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dc.contributor.authorClaassen, Cassidy W
dc.contributor.authorMumba, Daliso
dc.contributor.authorNjelesani, Mwansa
dc.contributor.authorNyimbili, Derrick
dc.contributor.authorMwango, Linah K
dc.contributor.authorMwitumwa, Mundia
dc.contributor.authorMubanga, Ellen
dc.contributor.authorMulenga, Lloyd B
dc.contributor.authorChisenga, Tina
dc.contributor.authorNichols, Brooke E
dc.contributor.authorHendrickson, Cheryl
dc.contributor.authorChitembo, Lastone
dc.contributor.authorOkuku, Jackson
dc.contributor.authorO'Bra, Heidi
dc.date.accessioned2021-07-12T14:36:39Z
dc.date.available2021-07-12T14:36:39Z
dc.date.issued2021-07-09
dc.identifier.urihttp://hdl.handle.net/10713/16177
dc.description.abstractINTRODUCTION: Daily pre-exposure prophylaxis (PrEP) for HIV prevention is highly effective, but not yet widely deployed in sub-Saharan Africa. We describe how Zambia developed PrEP health policy and then successfully implemented national PrEP service delivery. POLICY DEVELOPMENT: Zambia introduced PrEP as a key strategy for HIV prevention in 2016, and established a National PrEP Task Force to lead policy advocacy and development. The Task Force was composed of government representatives, regulatory agencies, international donors, implementation partners and civil society organisations. Following an implementation pilot, PrEP was rolled out nationally using risk-based criteria alongside a national HIV prevention campaign. NATIONAL SCALE-UP: In the first year of implementation, ending September 2018, 3626 persons initiated PrEP. By September 2019, the number of people starting PrEP increased by over sixfold to 23 327 persons at 728 sites across all ten Zambian provinces. In the first 2 years, 26 953 clients initiated PrEP in Zambia, of whom 31% were from key and priority populations. Continuation remains low at 25% and 11% at 6 and 12 months, respectively. LESSONS LEARNT: Risk-based criteria for PrEP ensures access to those most in need of HIV prevention. Healthcare worker training in PrEP service delivery and health needs of key and priority populations is crucial. PrEP expansion into primary healthcare clinics and community education is required to reach full potential. Additional work is needed to understand and address low PrEP continuation. Finally, a task force of key stakeholders can rapidly develop and implement health policy, which may serve as a model for countries seeking to implement PrEP.en_US
dc.description.urihttps://doi.org/10.1136/bmjopen-2020-047017en_US
dc.language.isoenen_US
dc.publisherBMJ Publishing Groupen_US
dc.relation.ispartofBMJ Openen_US
dc.rights© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.en_US
dc.subjectHIV & AIDSen_US
dc.subjecthealth policyen_US
dc.subjectpublic healthen_US
dc.titleInitial implementation of PrEP in Zambia: health policy development and service delivery scale-upen_US
dc.typeArticleen_US
dc.identifier.doi10.1136/bmjopen-2020-047017
dc.identifier.pmid34244265
dc.source.volume11
dc.source.issue7
dc.source.beginpagee047017
dc.source.endpage
dc.source.countryEngland


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