ECDC releases Pre-Exposure Prophylaxis Guidelines
The European Centre for Disease Control (ECDC) has issued an operational manual with a raft of recommendations for the design and implementation of Pre-Exposure Prophylaxis (PrEP) programmes.
These new guidelines aim to harmonise the efforts of countries in their design and implementation of PrEP programmes, according to the International Treatment Preparedness Coalition ITPCru.
The guidance is structured around 10 core principles of effective PrEP programmes, categorised as being relevant for preparatory (before a programme exists), new (under 24 months) and established (24 months and above) phases of PrEP implementation:
- Early and ongoing stakeholder engagement
- Implementation within a stigma-free environment
- Population wide access, based on need
- PrEP embedded in combination STI and HIV prevention, and sexual health programmes
- Proactive approach to raising PrEP awareness and demand creation
- Compliance with clinical and public health guidelines
- Use of standardised eligibility criteria to assess need
- Linkage into care
- Continuation of PrEP
- Monitoring and evaluation
It is noted that PrEP programmes will see higher demand if the drugs are offered for little or no cost, and if programmes support various PrEP taking methods – such as event-based or holiday PrEP alongside the standard daily dosing. National leaders are encouraged to collaborate with drug regulatory bodies in order to expand access and use of generic drugs in these programmes.
The guide also contains the experiences of different countries in their implementation of PrEP programmes in the hopes that other nations can borrow best practice and learn from their mistakes.
It is also important to note that in some countries, such as Russia, that whilst drugs such as TDF/FTC are approved for the prevention of HIV the drugs are still under patent until 2024 and are not provided by the state. Activists and patient organisations continue to challenge this status quo.
You can download a copy of the new ECDC guidelines here: https://www.ecdc.europa.eu/en/publications-data/HIV-PrEP-eueea-and-uk-implementation-standards-monitoring-guidance