Oral PrEP Training Materials

This AGYW Provider Training Package was developed by the OPTIONS Consortium. The purpose of these slides is to ensure that those embarking on the provision of AGYW services do not have to re-invent the wheel, and to provide a library of slides available to use for training. The slides have been developed for all categories of healthcare providers involved in the provision of PrEP. The slides are adaptable depending on the participants and have been developed with this flexibility in mind. Several attachments have been provided which are referred to in the presentations and provide more information on participatory activities. Please use the slide package as a guide and resource and adapt it to fit the needs of your country, participants and available time.

• Introduction — Provider Training Package: Effective Delivery of Oral Pre-Exposure Prophylaxis for Adolescent Girls and Young Women
• Module 1: Introduction to Oral PrEP
• Module 2: The Provision of PrEP in the Context of AGYW
• Module 3: Important Factors to Consider When Providing Oral PrEP to AGYW
• Module 4: Oral PrEP Provision for AGYW: Getting Started
• Module 5: Monitoring, Follow-Up and Adherence Support for AGYW on Oral PrEP
• Module 6: Wrapping Up
• Module 7: Addendum — Initiation and Clincical Management of Oral PrEP

The following attachments have been linked to in the training slides:

• Attachment 1: Introduction to the OPTIONS AGYW Training Package
• Attachment 2: Act Like a Man, Act Like a Woman
• Attachment 3: Group Activity: Exploring our Values
• Attachment 4: HIV Self-Perceptions of Risk and Attitudes toward AGYW
• Attachment 5: Tips for Conducting a Risk Assessment
• Attachment 6: Frequently Asked Questions (and Answers)
• Attachment 7a: Scenarios for Discussion
• Attachment 7b: Scenarios with Facilitators Notes to Guide Discussion

The Pre-exposure prophylaxis (PrEP) training package was developed by ICAP at Columbia University to support the implementation of PrEP. The training curriculum and tools serve as a foundation and may need to be adapted to specific contexts. As the use of PrEP is an evolving area, it is expected that these documents will require updating over time as new information regarding PrEP arises and implementation experiences accumulate.

The goal of the pre-exposure prophylaxis (PrEP) Training for Providers in Clinical Settings is to equip health care providers with the knowledge and skills necessary to provide PrEP to appropriate candidates and with high quality in order to decrease the risk of HIV infection.

The PrEP training curriculum includes the following components:

1. PrEP training slide set - The PowerPoint slide set was developed to facilitate the presentations and discussions throughout the training. When conducting the training, use this Trainer Notes document for reference. This document contains all of the slides for beginning the training program, the four modules, along with trainer notes/instructions for many of the slides and screen shots of various job aids/tools (contained within the participant folder) and ending the training program.
a. Note that slides #18, 33, and 48 should be adapted to the local country context.

2. PrEP trainer notes (including provider job aids) - The Trainer Notes were developed to support trainers and co-trainers to plan and implement the one day program. Each of the four modules provides technical content and also guidance on how to teach that content. In the PowerPoint slides included in each module, you will find the following: module time, learning objectives, interactive exercises, trainer notes/instructions and references. Suggested questions are also provided to help you engage and draw responses from participants.

3. Certification of participation template

Please visit the ICAP website here for translated and editable documents.

This PrEP training curriculum was developed by the Southern African HIV Clincians Society, in close collaboration with Wits RHI, ANOVA and OPTIONS with additional contributions from Gilead. The purpose of these slides is to ensure that teams and countries do not have to reinvent the wheel, as well as to have a library of slides available to countries and partners to utilize for quality training and presentation.

Please refer to the speakers notes at the bottom of each slide. Areas where country specific information will need to be adapted are highlighted, as the slides were developed in South Africa. Please use and adapt this curriculum as per your needs, but acknowledge the source. Suggested citation: Southern African HIV Clinicians Society and partners PrEP curriculum package February 2017.

From time to time these slides will be updated and the dates on the slides will be changed accordingly.

Module 1: Introducing PrEP

Module 1a: The Basics
Overview: A basic overview and introduction to PrEP. Intended for all.

• Why PrEP?
• Combination prevention: PrEP part of a combination prevention package
• What is PrEP?
• PrEP vs. PEP vs. ART
• PrEP in South Africa
• PrEP: Efficacy rates in clinical trials
• A brief overview on main research
• Overview of guidelines
• WHO, South African, Southern African HIV Clinicians Society

Module 1b: Additional Information — The evidence of PrEP effectiveness
Overview: A more detailed summary of PrEP research, for presentations where scientific/research aspects are required. Intended for clinicians; audience interested in the science and research of PrEP. Includes information from the following studies:

• PROUD, ATN113, Ipergay, AmPrEP, PATH-PrEP demo project, HPTN-067/ADAPT, Partners demo project, iPrEx, Strut, HPTN-073, ATN110, START

Module 2: Providing PrEP – The basics

Overview: This covers all the basics relating to the provision of PrEP. Intended for all. Click to download.

• Who is PrEP intended for?
• Contra-indications to PrEP
• PrEP in pregnancy
• Assessing risk
• Risk assessment
• Eligibility criteria
• Starting and stopping PrEP and effectiveness
• Stopping PrEP
• Cycling on and off PrEP
• Condom use and PrEP
• Combination prevention

Module 3: Working with different groups

Overview: This module explores different groups, different needs. We look at key populations, sensitisation, and some key points about working with different groups. Intended for all.

Due to file size limitations, this session has been broken into modules 3a-g, with each sub-section discussing one particular population. This module is meant to be integrated with all populations discussed.

• Module 3a: Overview of key populations and vulnerable populations — Why and what do we mean by sensitisation?, Stigma and stereo types, and the impact on healthcare, Sensitisation: creating the right environment
• Module 3b: Men who have sex with men
• Module 3c: Sex workers
• Module 3d: Adolescents and young people
• Module 3e: Sero discordant couples
• Module 3f: People who inject drugs
• Module 3g: Prisoners and PrEP

Module 4: Clinical management

Overview: Provides information to support clinical management of PrEP. Intended for clinicians and healthcare providers providing PrEP.

Due to file size limitations, this session has been broken into modules 4a-g, with each sub-section focused on a specific step in clinical management. This module is meant to be integrated.

• Module 4a: Getting started on PrEP
• Module 4b: Risks and side effects
• Module 4c: Stopping PrEP
• Module 4d: Supporting PrEP users
• Module 4e: PrEP - pregnancy and breast feeding
• Module 4f: PrEP dosing strategies

Module 5a: Sensitisation and communicating about PrEP

Overview: Cover practical points relating to communication about PrEP. Intended for all. Click to download.

• PrEP promotion and messaging
• Understanding user groups
• Communicating about PrEP
• Key messages — eligibility, condom use, counselling, education and awareness, safety and effectiveness, impact on lifestyle

Module 5b: Supporting effective PrEP pill taking and providing HIV risk reduction counselling

Overview: Cover practical points relating to counselling and risk reduction. Intended for all. Click to download.

• PrEP counselling
• Integrating PrEP into standard HIV risk reduction practices
• Case studies
• PrEP and HIV risk reduction
• Strategies to support effective pill taking
• Good counseling messages
• Support for effective pill taking
• Integrated PrEP counselling strategies

Module 6: Case studies

A library of case studies for training, use as appropriate for audience and time available. Click to download.

The WHO has developed a toolkit containing a series of modules for a range of stakeholders to support them in the consideration, planning, introduction and implementation of oral PrEP.

The toolkit contains specific training modules for:

• Clinical training
• Pharmacist training
• Provider testing training

Click here to access all modules, and click here to access the eLearning version of the toolkit.

LVCT Health developed a training kit to equip providers with skills around stereotyping, stigma and discrimination towards adolescent girls and young women and female sex workers. The materials were developed as part of the BMGF sponsored IPCP demonstration project and the PEPFAR funded DREAMS project.