PrEP for Pregnant and Breastfeeding Women – Clinical Guidelines and Training Package

Evidence shows that offering PrEP is a safe and effective HIV prevention strategy for pregnant and breastfeeding women.

Guidance from the World Health Organization (WHO) supports provision of PrEP to pregnant and breastfeeding women (PBFW) who are at continuing substantial risk of HIV infection. Evidence has shown that women are at increased risk of HIV acquisition during pregnancy and breastfeeding, and that women who become infected with HIV during pregnancy and breastfeeding have a higher risk of transmitting HIV to their infants as compared to women who became infected with HIV before becoming pregnant.

Developed by the CHOICE collaboration of the EpiC and RISE programs, with support from PEPFAR through USAID, the PrEP for Pregnant and Breastfeeding Women Toolkit is designed for use by policy makers, program implementers, and healthcare workers to expand provision of PrEP to PBFW. The evidence-informed materials are designed to be adapted to reflect local context and priorities, national policy and guidelines, and implementation context surrounding provision of PrEP to PBFW.

At the core of this package are sample Clinical Practice Guidelines which include eligibility screening and management recommendations, with a specific focus on clinical considerations warranting special attention in this population. Additionally, the package includes adaptable implementation support and training materials including an implementation guide, a facilitators guide and training PowerPoint, case studies, a pre/post training knowledge test, a facility assessment tool (to assess readiness to offer PrEP within MNH units), surveillance tools and a pregnancy wheel job aid that includes key messages on PrEP for PBFW for providers.

These materials are designed to help Ministries of Health, program managers and trainers expand access to high-quality PrEP for PBFW using a facility-based approach for training, capacity building and mentorship. The materials are designed to support providers who care for PBFW which may include Maternal and Newborn Health providers who deliver ANC and PNC services (including family planning), and PrEP providers who care for women during the pregnancy or postnatal period.


Demand Generation Package

Providing PrEP for Pregnant and Breastfeeding Women

Providing PrEP to Pregnant and Breastfeeding Women Training Package

Implementation and Surveillance Materials

  • Assessment of Facility Readiness for PrEP Provision in Antenatal and Postnatal Care Services (English / French)
  • Surveillance Tools for PrEP Use by Pregnant and Breastfeeding Women — Briefer (English / French)
  • Active Safety Surveillance of Maternal and Infant Health Outcomes for Pregnant and Breastfeeding users of HIV PrEP — Case Report Form (English / French)
  • Maternal Child Health PrEP Surveillance Register (English / French)
  • CHOICE PrEP for PBFW Pregnancy Wheel (English / French)

Research and Insights

  • HIV Prevention Options During Pregnancy and Breastfeeding—What’s in the Pipeline? (Presentation / Recording)
Type: Document
Publication Date: December 16, 2020
Source: CHOICE