- PrEP from drop-in centers and with peer-led approaches for reaching female sex workers, Ethiopia
- Target clients
- Building blocks peer-led approaches for PrEP delivery – Pre COVID-19
- PrEP screening
- PrEP initiation
- PrEP early follow-up (0-3 months)
- PrEP continuation: PrEP refill
- PrEP continuation: Routine clinical follow-up
- COVID-19 related adaptations to model
- COVID-19 Building blocks for peer-led approaches for PrEP delivery
- More...
PrEP was piloted in Ethiopia between December 2018 and September 2019 in selected drop-in centres, which are specially designed community clinics that provide female sex workers with comprehensive HIV prevention, care and treatment services. During the pilot, early adopters of PrEP were selected to be ambassadors to create demand for PrEP. This enabled the next phase where female sex workers were fully engaged in the development of the PrEP demand creation materials that were disseminated through peer-educator community sexual and social networks.
At entry to care (HIV testing), all female sex workers who tested negative for HIV were counselled around PrEP. Further information on the phases and content of the PrEP service delivery model is included in the building blocks below.
Clients’ positive feedback for the peer-led approach included reduced stigma and discrimination, improved ability to find and reach those not yet served by the health system and increased demand creation and service uptake. It was noted that the development of quality counselling and assessment skills for the peers and healthcare providers is crucial for the success of this approach.
Target clients
Female sex workers and discordant partners of female sex workers who are living with HIV
Building blocks peer-led approaches for PrEP delivery – Pre COVID-19
PrEP screening
What
Counselling on combination HIV prevention and treatment adherence
Substantial risk screening
HIV testing
HBsAg test
When
At entry point (first visit)
Where
Drop in centre
Who
Service provider
Lab and pharmacy personnel
PrEP initiation
What
Counselling on combination HIV prevention and treatment adherence
Substantial risk screening
Assess for signs of STI or ARV side effects
When
First visit
Where
Drop-in centre
Who
Service provider
Lab and pharmacy personnel
PrEP early follow-up (0-3 months)
What
Counselling on combination HIV prevention, treatment adherence and risk reduction
Substantial risk screening
Assess for signs of STI or ARV side effects
HIV testing
When
At 1 month
Where
Drop-in centre
Who
Service provider
Lab and pharmacy personnel
PrEP continuation: PrEP refill
What
Counselling on combination HIV prevention and treatment adherence
Substantial risk screening
Assess for signs of STI or ARV side effects
HIV testing (every 3 months)
When
Every 1 month for the first 3 months and every 3 months afterwards
Where
Drop-in centre
Who
Service provider
Lab and pharmacy personnel
PrEP continuation: Routine clinical follow-up
What
Counselling on combination HIV prevention and treatment adherence
Substantial risk screening
Assess for signs of acute HIV infection, STI or ARV side effects
HIV testing every 3 months
When
Every 1 month for the first 3 months and every 3 months afterwards.
Drop in appointments if adverse side effects experiences
Where
Drop-in centre
Who
Service provider
Lab and pharmacy personnel
COVID-19 related adaptations to model
In response to COVID-19, three monthly dispensing of PrEP (3MMD) was instituted, with monthly follow-up and adherence counselling taking place telephonically. Awareness raising activities were shifted online.
COVID-19 Building blocks for peer-led approaches for PrEP delivery
PrEP screening
What
Counselling on combination HIV prevention and treatment adherence
Substantial risk screening
HIV testing, HBsAg test
COVID-19 prevention education
When
At entry point (first visit)
Where
Drop-in centre
Who
Service provider
Lab and pharmacy personnel
PrEP initiation
What
Counselling on combination HIV prevention and treatment adherence
Substantial risk screening
Assess for signs of STI or ARV side effects
COVID-19 prevention education
When
First visit
Where
Drop-in centre
Who
Service provider
Lab and pharmacy personnel
PrEP initial follow-up
What
Counselling on combination HIV prevention, treatment adherence and risk reduction
Substantial risk screening
Assess for signs of STI or ARV side effects
HIV testing
COVID-19 prevention education
When
At 3 months (with monthly telephonic follow-up)
Where
Drop-in centre / telephonic
Who
Service provider
Lab and pharmacy personnel
PrEP continuation: Routine clinical follow-up
What
Counselling on combination HIV prevention and treatment adherence
Substantial risk screening
Assess for signs of STI or ARV side effects
COVID-19 prevention education
When
3 monthly (with monthly telephonic follow-up)
Where
Drop-in centre / telephonic
Who
Service provider
Lab and pharmacy personnel
PrEP continuation: Routine clinical follow-up
What
Combination HIV prevention and treatment adherence counselling
Substantial risk screening, assess for signs of acute HIV infection or STI, HIV testing every 3 months
COVID-19 prevention education
When
3 monthly, or more frequently if required due to adverse reactions
Where
Drop-in centre
Who
Service provider
Lab and pharmacy personnel
