Disparities in PrEP Use and Unmet Need in PEPFAR Programs
Author Information
Author(s): Trena I. Mukherjee, Mitchell Yep, Megan Koluch, Sisay Alemayehu Abayneh, Gizachew Eyassu, Elizabeth Manfredini, Sara Herbst
Primary Institution: USAID
Hypothesis
What are the disparities in PrEP provision across PEPFAR-supported countries?
Conclusion
PrEP use relative to population need varied greatly by country and subpopulation across PEPFAR programs, indicating a need for improved access and tailored prevention strategies.
Supporting Evidence
- In FY23, 1,760,888 people initiated PrEP, but 1,736,144 tested positive for HIV.
- 40% of countries had fewer PrEP users than positive HIV tests.
- Adolescents and young people had the highest median PrEP-to-need ratio.
Takeaway
This study looks at how many people need PrEP to prevent HIV and how many are actually getting it, showing that many people still need help to access it.
Methodology
Analyzed FY2023 Monitoring, Evaluation, and Reporting results from 48 PEPFAR-supported countries to calculate PrEP-to-need ratios.
Potential Biases
Key population status is self-reported, which may under-report actual numbers due to stigma and discrimination.
Limitations
Data is reported cross-sectionally and in aggregate, which may lead to duplication and underestimation of PrEP use.
Participant Demographics
Included various populations such as adolescents, young people, and key populations like sex workers and men who have sex with men.
Digital Object Identifier (DOI)
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