AUTHOR=Venter Willem D. F. TITLE=Pre-exposure Prophylaxis: The Delivery Challenge JOURNAL=Frontiers in Public Health VOLUME=6 YEAR=2018 URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2018.00188 DOI=10.3389/fpubh.2018.00188 ISSN=2296-2565 ABSTRACT=

HIV pre-exposure prophylaxis (PrEP), despite its efficacy, has been slow in uptake throughout the world. This article discusses the operational and service delivery complexity, based on early real-world experience, with some recommendations on how this promising intervention could be made more available. Currently, access to PrEP is made complex by restricting delivery to dedicated health facilities, as well as requirements around HIV testing and toxicity monitoring. Expanding to verticalized services that focus on well-defined populations where HIV testing and treatment programmes already exist, has proven relatively simple. Providing PrEP outside of this environment has yet to be demonstrated at any scale, and will likely require innovative thinking addressing the regulatory and clinical environment, so as to ensure easier access to this promising HIV prevention tool.