Scaling-up PrEP Delivery in Sub-Saharan Africa: What Can We Learn from the Scale-up of ART?

  • Gabrielle O’MalleyEmail author
  • Gena Barnabee
  • Kenneth Mugwanya
The Science of Prevention (JD Stekler and JM Baeten, Section Editors)
Part of the following topical collections:
  1. Topical Collection on The Science of Prevention


Purpose of Review

Clinical trials have found that PrEP is highly effective in reducing risk of HIV acquisition across types of exposure, gender, PrEP regimens, and dosing schemes. Evidence is urgently needed to inform scale-up of PrEP to meet the ambitious WHO/UNAIDS prevention target of 3,000,000 individuals on PrEP by 2020.

Recent Findings

Successful models of delivering HIV services at scale evolved from years of formal research and programmatic evidence. These efforts produced lessons-learned relevant for scaling-up PrEP delivery, including the importance of streamlining laboratory tests, expanding prescription and management authority, differentiating medication access points, and reducing stigma and barriers of parental consent for PrEP uptake. Further research is especially needed in areas differentiating PrEP from ART delivery, including repeat HIV testing to ensure HIV negative status and defining and measuring prevention-effective adherence.


Evidence from 15 years of ART scale-up could immediately inform a public health approach to PrEP delivery.


Pre-exposure prophylaxis (PrEP) Scaling-up PrEP implementation Sub-Saharan Africa HIV/AIDS Anagogical reasoning 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Gabrielle O’Malley
    • 1
    Email author
  • Gena Barnabee
    • 1
  • Kenneth Mugwanya
    • 1
  1. 1.Department of Global HealthUniversity of WashingtonSeattleUSA

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