WHO IMPLEMENTATION TOOL FOR PRE-EXPOSURE PROPHYLAXIS (PrEP) OF HIV INFECTION: MODULE 1 CLINICAL. PDF Download

Author: world health organization
Publisher:
ISBN:
Category :
Languages : en
Pages : 0

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Publisher: World Health Organization
ISBN: 9240053697
Category : Medical
Languages : en
Pages : 46

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Author: Cara P Nalagan
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Despite compelling evidence behind the efficacy of pre-exposure prophylaxis (PrEP) in preventing human immunodeficiency virus (HIV) acquisition and its introduction in 2012, the prescription of PrEP has remained low (Silapaswan, Krakower, & Mayer, 2016). At the Asian and Pacific Islander Wellness Center (API), an urban primary care clinic in San Francisco, suboptimal PrEP implementation was related to a lack of standardized practice and routine HIV risk screening for PrEP provision. A doctorate of nursing (DNP) project was implemented to initiate a standardized HIV risk screening protocol for identifying HIV risk and PrEP eligibility to increase PrEP implementation at API. The impact of this protocol demonstrated an increase in the PrEP implementation cascade, particularly in HIV risk identification, PrEP offer, and evaluation of at-risk patients for PrEP uptake (initiation). During implementation of the HIV risk screening protocol, however, inconsistent clinical staff compliance with the routine screening tool led to an inadequate increase in PrEP offer for patients who tested positive for a sexually transmitted infection (STI). This indicates a need for further reinforcement of standardized practice and clinical staff education on the importance of combining HIV risk screening and PrEP, with emphasis on the significant risk for HIV infection associated with positive STI, to effectively promote patient outcomes. Implications for further research include validation of the HIV PrEP screening tool used in the HIV risk screening protocol as a model for PrEP implementation in the primary care setting.

Author: World Health Organization
Publisher: World Health Organization
ISBN: 9240057420
Category : Medical
Languages : en
Pages : 50

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WHO's pre-exposure prophylaxis (PrEP) for HIV infection implementation tool contains modules for a range of stakeholders to support them in the consideration, planning, introduction, implementation and roll-out of PrEP services. The modules can be used on their own or in combination. In addition, there is a module for individuals interested in or already taking oral PrEP. The STI integration module compiles existing WHO recommendations, systematic scientific literature reviews and other relevant publications to provide suggested implementation approaches. It is the product of collaboration among many experts, community organizations and networks, providers, implementers, researchers and partners from all regions. The STI integration module is divided into 2 parts: the first focuses on programme managers and other decision-makers, and the second on health care workers. People who use PrEP will also benefit from it.

Author: World Health Organization
Publisher: World Health Organization
ISBN: 9240097236
Category : Medical
Languages : en
Pages : 60

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This 2024 update of the Provider module for oral and long-acting PrEP of the WHO PrEP Implementation Tool replaces the 2017 Clinical Module. The module integrates clinical service delivery guidance for all three WHO recommended PrEP products (oral PrEP, the dapivirine vaginal ring and long acting injectable cabotegravir). It provides practical support and important considerations for the safe and effective PrEP provision by a range of providers, including physicians, nurses, clinical officers, community health workers, pharmacists and lay and peer providers, in either clinical or community settings.

Author: Tanya Clesie Cavallaro-Moretti
Publisher:
ISBN:
Category : AIDS (Disease)
Languages : en
Pages : 152

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The Pre-Exposure Prophylaxis (PrEP) guidelines 2014, supported by scientific evidence, recommends the use of antiviral therapy (ART) prophylaxis to prevent human immunodeficiency virus (HIV) infection in patients at high-risk for HIV infection. The literature is limited on PrEP guidelines use in the urgent care (UC) settings. The purpose of this project was to determine the knowledge of urgent care providers regarding the PrEP guidelines and their practices of assess patients at high-risk for HIV infection. Additionally, the project aimed to determine the feasibility of providers to prescribe, implement and follow patients to whom they have prescribed the PrEP guidelines. The diffusion of innovation theory was used as the framework of this project to assist in process of the adoption of the PrEP in the urgent care settings. This project used quantitative descriptive methodology using a survey and chart review that identified the current HIV preventive practice in the UC in Arizona. There were four clinical questions (CQs) that investigated the healthcare provider's knowledge, practice, and attitude toward HIV prevention. There were 208 HIV screening tests ordered in 2016 in the UC, and there were 20 patients that received ART prophylaxis prescribed by nurse practitioner and from those, only six prescribed Truvada® were for PrEP. Truvada® was given to 2.88% of 208 of the patients screened for HIV. The project identified barriers to implementation of the PrEP guidelines in UC and the DIT can assist with diffusion of PrEP guidelines. The project identified algorithms to facilitate the application of prep guidelines into urgent care. The applicability of the PrEP guidelines into the UC settings was investigated and the UC is prepared to indicate ART to those who have clinical indications for PrEP, in addition to HIV screening and education.

Author:
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ISBN:
Category : HIV infections
Languages : en
Pages : 0

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The purpose of this implementation guide is to assist clinicians and/or agencies with integrating PrEP services into their current services. This guide will provide step-by-step instructions and resources for offering PrEP services. This guide can be used partly or completely for the implementation of PrEP services

Author: Julie Kay Schexnayder
Publisher:
ISBN:
Category : Community health services
Languages : en
Pages : 176

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Pre-exposure prophylaxis (PrEP) effectively reduces the risk of Human Immunodeficiency Virus (HIV) infection. PrEP implementation in public health clinics is suggested for increasing PrEP access; However, it is unclear if these venues can reduce the disparities in PrEP use that are observed for Black and Latinx adults. We analyzed data from health departments completing their first PrEP program year between June 1, 2016 and June 30, 2019. We estimated PrEP coverage and adherence in Black and Latinx clients. Semi-structured interviews were conducted with multidisciplinary public health workers (n=6). The Consolidated Framework for Implementation guided a thematic analysis of interviews. Of the 433 PrEP clients, 52.0% were non-Hispanic Black and 8.9% were Hispanic/Latinx. PrEP to need ratios were greater for White clients than for Black or Latinx clients at five of the nine health departments. The average medication possession ratio for Black and Latinx PrEP clients (.79) approached effective daily adherence levels. However, a single prescription was filled for 25.0% of Black and Latinx clients. Qualitative data indicated compatibility issues between PrEP services delivery and community preferences and needs. Challenges integrating longitudinal follow-up practices, and complex PrEP re-enrollment procedures emerged as additional factors influencing PrEP outcomes. The results of this dissertation indicate that public health clinics vary in their ability to deliver all components of PrEP clinical monitoring and in their ability to increase PrEP coverage in Black and Latinx adults. Tailoring of PrEP services to Black and Latinx adults may be necessary to optimize PrEP coverage and adherence.

Author: Pamela M. Murnane
Publisher:
ISBN:
Category :
Languages : en
Pages : 81

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Pre-exposure prophylaxis (PrEP) is a promising new HIV-1 prevention strategy, with demonstrated efficacy from four randomized clinical trials. However, two trials of PrEP, both among heterosexual African women, did not find efficacy for protection against HIV-1. While adherence to PrEP has been proposed as the primary driver of the range of results across trials, other factors warrant investigation. This dissertation work contributes to our understanding of behavioral and biological factors that influence the effectiveness of PrEP and aims to inform PrEP implementation strategies. This dissertation was conducted within the Partners PrEP Study, a placebo-controlled, randomized trial of daily oral PrEP among 4747 heterosexual HIV-1 serodiscordant couples (one partner is infected with HIV-1 and the other partner is uninfected) in Kenya and Uganda which demonstrated high efficacy for two daily oral PrEP regimens, tenofovir alone and co-formulated tenofovir-emtricitabine. In a series of secondary analyses of data from the Partners PrEP Study, we evaluated the effect of PrEP among high-risk subgroups to determine whether efficacy was sustained in the context of high HIV exposure, we estimated the causal effect of PrEP when adherence was estimated to be high by applying multiple methods to correct for non-adherence in randomized trials, and we assessed whether PrEP adversely impacted hormonal contraceptive effectiveness for pregnancy prevention, as young women are a priority population for HIV prevention. The work presented here supports the hypothesis that the key driver of divergent PrEP trial results was adherence, and indicates that oral PrEP is highly effective for women and men, reducing HIV-1 risk by over 80% when estimated to have been used with high adherence. These analyses contribute to a more nuanced understanding of how PrEP works and inform guidelines for initiating PrEP among persons at risk of HIV-1 acquisition.

Author: World Health Organization
Publisher: World Health Organization
ISBN: 9240085130
Category : Medical
Languages : en
Pages : 160

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To ensure that countries can effectively benefit from digital health investments, “digital adaptation kits” (DAKs) are designed to facilitate the accurate reflection of WHO’s clinical, public health and data use guidelines in the digital systems that countries are adopting. DAKs are operational, software-neutral, standardized documentations that distil clinical, public health and data use guidance into a format that can be transparently incorporated into digital systems. For this particular DAK, the operational requirements are based on systems that provide the functionalities of digital tracking and decision support (DTDS) and include components such as personas, workflows, core data elements, decision-support algorithms, scheduling logic and reporting indicators. Web annexes provide certain components in additional detail including: data dictionary (Web Annex A), decision-support logic (Web Annex B), indicator definitions (Web Annex C), and functional and non-functional requirements (Web Annex D). Data elements within the DAK (Web Annex A) are mapped to standards-based terminology, such as the International Classification of Diseases (ICD), to facilitate interoperability. This DAK focuses on providing the content requirements for a DTDS system for HIV care used by health workers in primary health care settings. It also includes cross- cutting elements focused on the client, such as self-care interventions.