PrEP for Pregnant and Breastfeeding People – Clinical Guidelines and Training Package
Evidence shows that offering PrEP is a safe and effective HIV prevention strategy for pregnant and breastfeeding people.
Guidance from the World Health Organization (WHO) supports provision of PrEP to pregnant and breastfeeding people (PBFP) who are at continuing substantial risk of HIV infection. Evidence has shown that people are at increased risk of HIV acquisition during pregnancy and breastfeeding, and that people who become infected with HIV during pregnancy and breastfeeding have a higher risk of transmitting HIV to their infants as compared to people 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 People Toolkit is designed for use by policy makers, program implementers, and healthcare workers to expand provision of PrEP to PBFP. 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 PBFP.
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 PBFP for providers.
These materials are designed to help Ministries of Health, program managers and trainers expand access to high-quality PrEP for PBFP using a facility-based approach for training, capacity building and mentorship. The materials are designed to support providers who care for PBFP which may include Maternal and Newborn Health providers who deliver ANC and PNC services (including family planning), and PrEP providers who care for people during the pregnancy or postnatal period.
- Implementation Guide (English / French)
- Facilitator Guide (English / French)
- Learner Guide (English / French)
- PrEP for PBFP Course PowerPoint (English / French)
- Training Pre- and Post-Test (English / French)
- Test Answer Key (English / French)
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 People — 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 PBFP Pregnancy Wheel (English / French)
Research and Insights
PANCAP PrEP Knowledge Suite
The Pan Caribbean Partnership Against HIV/AIDS (PANCAP) Coordinating Unit and Pan American Health Organization (PAHO) have developed a collection of knowledge resources for PrEP. The suite consists of social media content, digital brochures, technical guidelines, training and capacity-building materials, and more.
Daily Oral PrEP, Event-Driven PrEP, and PrEP Ring Template Guidelines
These adaptable guidelines can be used to support the development and adoption of national guidelines that align with WHO PrEP guidance, including recommendations for daily and event-driven oral PrEP and the monthly PrEP ring. The document includes prompts for national-level consideration during the guideline adaptation process.
An implementation model for scaling up oral pre-exposure prophylaxis in Kenya: Jilinde project
In this article, the authors describe the conceptual design of the Jilinde project, which implemented oral PrEP as a routine service at a public health scale in Kenya. The authors describe the overlapping domains of supply, demand, and government and community ownership, which combine to produce a learning laboratory environment to explore the scale-up of…
Getting Rollout Right: Lessons from Oral PrEP
Insights from a decade of experience with oral PrEP programs offer key lessons for developing and delivering HIV prevention products so that they reach those who could most benefit. The Prevention Market Manager project has developed a suite of resources to frame these insights and explore their implications. It’s vital that the field learns from…
Guidance for Providing Informed-choice Counseling on Sexual Health for Women Interested in Pre-exposure Prophylaxis
This guidance is focused on Kenya and South Africa. Its purpose is to promote informed decisionmaking on sexual health for women who have expressed interest in using PrEP as part of their HIV risk-reduction strategy.
Zambia Ending AIDS Campaign Materials
JSI’s USAID DISCOVER-Health Project contributes towards HIV epidemic control in Zambia and has produced a number of PrEP campaign materials. See below! Tools PrEP Your Client for Protection in 5 Easy Steps Be Ready with PrEP Fact Sheet Be Ready with PrEP Frequently Asked Questions Zambia Ending AIDS Posters Videos Introduction to Zambia Ending AIDS…