Many people in African PrEP programmes stop and restart PrEP

While many PrEP programmes report substantial drop-off rates, it's common for PrEP users to restart later, data from three different PrEP demonstration projects in Kenya, Tanzania and Lesotho presented to the 23rd International AIDS Conference (AIDS 2020: virtual) show.

“Cycling on and off PrEP repeatedly is common," Jane Mutegi of Jhpiego told the conference. "Current PrEP indications mirror antiretroviral therapy indications, but providers should anticipate episodic use and not assume indefinite, continuous use is the only effective use, or the best dosing option for all.”

As aidsmap.com has already reported from the conference, PrEP appears to have led to significant reductions in HIV infections in a large African study, despite relatively low levels of use. We speculated that this may be due to people who are using PrEP doing so episodically, only when they feel at risk, despite being told to use it daily.

Patterns of PrEP use in Kenya, Tanzania and Lesotho

Mutegi and colleagues looked at patterns of PrEP use in three different and varied PrEP demonstration projects in Africa that ended last year. The first and largest was the Gates Foundation-financed Jilinde project, which enrolled 32,963 people in Kenya, mainly but not exclusively from key populations, between February 2017 and November 2019. Read more via AIDSmap

Mutegi J et al. Monitoring characteristics of episodic HIV pre-exposure prophylaxis (PrEP) use among over 40,000 clients in sub-Saharan African countries prescribed daily oral PrEP: Indefinite, continuous use neither the reality nor the goal, 23rd International AIDS Conference (AIDS 2020: Virtual), abstract OAE07, 2020.

Chakare T et al. HIV risk perception and salience are paradoxically associated with Pre-Exposure Prophylaxis (PrEP) discontinuation among adolescent girls and young women in Lesotho. 23rd International AIDS Conference (AIDS 2020: Virtual), abstract OAD06, 2020.

Patel P et al. Uptake of Pre-Exposure Prophylaxis (PrEP) among Adolescent Girls and Young Women in PEPFAR-supported Countries, 2017-2019. 23rd International AIDS Conference (AIDS 2020: Virtual), abstract OAC0803, 2020.