WHO implementation tool for pre-exposure prophylaxis of HIV infection

WHO implementation tool for pre-exposure prophylaxis (PrEP) of HIV infection

Publication details

Publication date: July 2017
Languages: English
WHO reference number: WHO/HIV/2017.17


Following the WHO recommendation in September 2015 that “oral pre-exposure prophylaxis (PrEP) should be offered as an additional prevention choice for people at substantial risk of HIV infection as part of combination HIV prevention approaches”, partners in countries expressed the need for practical advice on how to consider the introduction of PrEP and start implementation.

In response, WHO has developed this series of modules to support the implementation of PrEP among a range of populations in different settings.

Tool modules

Module 1: clinical

This module seeks to provide an overview of relevant information for clinicians, including physicians, nurses and clinical officers, who are providing PrEP in clinical settings. It describes important considerations when starting PrEP in an individual and monitoring PrEP use.

Module 2: community educators and advocates

For PrEP services to reach populations in an effective and acceptable way, community educators and advocates are needed to increase awareness about PrEP in their communities. This module provides up-to-date information on PrEP that should be considered in community-led activities that aim to increase knowledge about PrEP and generate demand and access.

Module 3: counsellors

This module is for staff who counsel people as they consider PrEP or start taking PrEP and support them in addressing issues around coping with side-effects and adherence strategies. Those who counsel PrEP users may be lay, peer or professional counsellors and healthcare workers, including nurses, clinical officers and doctors.

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 that they can consider how PrEP could be most effectively implemented in their own settings. It also contains a series of frequently asked questions about PrEP, with related answers.

Module 5: monitoring and evaluation

WHO implementation tool for pre-exposure prophylaxis (PrEP) of HIV infection - 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 PrEP for safety and effectiveness, suggesting core and additional indicators for site-level, national and global reporting.
Module 5 will be published soon.

Module 6: pharmacists

This module is for pharmacists and people working in pharmacies under a pharmacist’s supervision. It provides information on the medicines used in PrEP, including the optimal storage conditions. It also gives suggestions for how pharmacists and pharmacy staff can monitor PrEP adherence and support PrEP users to take their medication regularly.

Module 7: regulatory officials

WHO implementation tool for pre-exposure prophylaxis (PrEP) of HIV infection - Module 7: regulatory officials

This module is for national authorities in charge of authorizing the manufacturing, importation, marketing and /or control of antiretroviral medicines used for HIV prevention. It provides information on the safety and efficacy of PrEP medicines.
Module 7 will be published soon.

Module 8: site planning

This module is for people involved in organizing PrEP services at specific sites. It outlines the steps to be taken in planning a PrEP service and gives suggestions for personnel, infrastructure and commodities that could be considered when implementing PrEP.

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 reach those who could benefit most from PrEP, and in which settings PrEP services could be most cost-effective.

Module 10: testing providers

This module is for people who are responsible for providing testing services at PrEP sites and associated laboratories. It offers guidance in selecting relevant testing services, including appropriate screening of individuals before PrEP is initiated and monitoring while they are taking PrEP. Information is provided on testing for HIV, creatinine, hepatitis B and C virus, pregnancy and sexually transmitted infections.

Module 11: PrEP users

This module provides information for people who are interested in taking PrEP to reduce their risk of acquiring HIV and people who are already taking PrEP – to support them in their choice and use of PrEP. This module gives ideas for countries and organizations implementing PrEP to help them develop their own tools.