Yale University

Implementation science of pre-exposure prophylaxis: preparing for public use.

TitleImplementation science of pre-exposure prophylaxis: preparing for public use.
Publication TypeJournal Article
Year of Publication2010
AuthorsUnderhill, Kristen, Don Operario, Matthew J. Mimiaga, Margie R. Skeer, and Kenneth H. Mayer
JournalCurrent HIV/AIDS reports
Date Published2010 Nov
KeywordsAnti-HIV Agents, Attitude to Health, Clinical Trials as Topic, Government Regulation, Guidelines as Topic, Health Communication, Health Knowledge, Attitudes, Practice, Health Planning, Health Planning Guidelines, Health Policy, Health Promotion, Health Services Needs and Demand, HIV Infections, Humans, Patient Compliance, Risk Reduction Behavior, Risk-Taking, Sexual Behavior
AbstractAs efficacy trials of antiretroviral pre-exposure prophylaxis (PrEP) continue, a growing literature has begun anticipating the potential challenges of implementing PrEP for HIV prevention. These efforts coincide with a shift toward combination interventions for preventing HIV, which integrate biomedical, behavioral, and structural components. The optimal implementation of PrEP would exemplify this combination model, incorporating not only PrEP drugs, but also HIV testing, safety screening, behavioral interventions addressing adherence and risk behavior, and long-term monitoring. Efforts to plan for PrEP implementation therefore present an opportunity to advance the science of implementation and delivery in HIV prevention, in order to better address the challenges of scaling up combination approaches. We review the published and unpublished literature on PrEP implementation, organizing themes into five categories: scientific groundwork, regulatory and policy groundwork, stakeholder and infrastructure groundwork, delivery, and long-term monitoring. The lessons from PrEP planning can benefit the scale-up of future combination interventions.
Alternate JournalCurr HIV/AIDS Rep

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