Guidance: Standard Operating Procedures for Addressing Partner Relationships and Gender-Based Violence in Pre-Exposure Prophylaxis (PrEP) Services
Standard Operating Procedure Guidance
Evidence has shown that intimate partner violence (IPV) may act as a barrier to accessing HIV services, including PrEP services. IPV is associated with lower PrEP uptake and adherence and increased PrEP interruption among cisgender women. Although cisgender women have made up the majority of participants in research on PrEP and IPV to date, it is likely that IPV has similar impacts among other populations as well. Likewise, while other forms of gender-based violence (GBV), such as non-partner sexual violence, may have similar effects on PrEP use, less is currently known about their impact.
This standard operating procedure (SOP) guidance was developed under the USAID-funded CHARISMA project and the CHOICE collaboration of the EpiC and RISE projects and adapted for multiple PrEP methods under the USAID-funded MOSAIC project. The guidance can be used by pre-exposure prophylaxis (PrEP) program staff to screen for and address GBV in PrEP services. This resource includes guidance for adapting the SOP to the local context and clinic processes.
The SOP guidance outlines procedures for identifying clients who are experiencing GBV – especially IPV and non-partner sexual violence – and providing first-line support and referrals for clients who disclose experiences of violence. The resource also provides counseling messages to help clients decide whether to talk to their partner(s) about their PrEP use and strategies for using PrEP with or without their partner’s knowledge.
The PrEP Job Aid for Addressing Partner Relationships supports implementation of SOPs developed using the SOP guidance document. This 2-page flowchart provides step-by-step instructions for discussing partner relationships and responding to GBV with PrEP clients and instructions for adapting the job aid to the local context and clinic processes.
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