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Countries in sub-Saharan Africa have progressively scaled up oral PrEP as part of combination HIV prevention. Initial scale-up efforts have generated progress, drawing lessons from existing HIV interventions, such as antiretroviral therapy and biomedical prevention. However, beset by unprepared health systems, scale-up has been slow. This review synthesises literature on essential considerations for PrEP scale-up, highlighting the importance of health system adaptability and responsiveness.

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