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Table 1 Service delivery models for pre-exposure prophylaxis (PrEP) for HIV prevention for people who inject drugs identified in this study

From: Pre-exposure prophylaxis (PrEP) for HIV prevention among people who inject drugs: a global mapping of service delivery

Model

Key characteristics

Countries[a,b]

High-income

Low- and middle-income

Clinic-based PrEP delivery

• Delivered at fixed healthcare facilities, e.g., hospitals, sexual and reproductive health clinics

• Commonly involves specialist HIV or sexual health doctor responsible for PrEP prescribing

• Medication dispensed tends to be dispensed at the same healthcare facility or affiliated pharmacies

• Usually no other harm reduction services available at the same site

Australia, Croatia,

UK (England and Scotland)[c],

France, Germany, Italy, Luxembourg, Malta, New Zealand, Portugal, South Korea, USA

Kenya, Namibia, Thailand, Viet Nam

Delivery linked with drug dependence treatment services

• Delivered at fixed healthcare facilities where drug dependence treatment services are provided (methadone clinics)

USA

Kyrgyzstan, Ukraine

Community-based PrEP delivery and peer-led outreach

• PrEP delivered in community-based clinics or drop-in centers and community pharmacies

• PrEP services usually linked with other harm reduction services provided in the community settings, especially needle and syringe programs [25]

• Peers may be used to increase PrEP awareness through outreach [26, 28] and facilitate linkage to community-based clinics or drop-in centers

Canada, Czech Republic,

France, Spain, UK (Scotland)[c], USA

Kenya, Namibia, South Africa, Thailand, Ukraine, Viet Nam

Hybrid model

• Hybrid model where community-based outreach activities, often involving peers, provide linkages to healthcare facilities where PrEP is initiated

• PrEP drugs are usually dispensed at a community pharmacy

• May involve non-clinical staff to facilitate PrEP initiation, including completion of relevant forms

• Follow-up often undertaken by peer-led outreach staff

Canada, New Zealand, Spain, UK (Scotland)[c]

Kenya, Myanmar, South Africa, Ukraine

Online access

• Can be provided by non-governmental organizations (NGOs) or the private sector

• Online outreach workers provide instructions on how to obtain services at NGOs or affiliated clinics, including for those who wish to access PrEP privately

• Access to anonymous PrEP assessment tools and/or online counselors

• Online purchase of PrEP medication

 

Russian Federation, Ukraine

  1. aPrEP services for people who inject drugs were also identified in Georgia, Guatemala, and North Macedonia. However, insufficient data were available for these countries to categorize service delivery models
  2. bCountries were classified according to World Bank country income levels as of December 28, 2022: https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups
  3. cDue to the devolved system of the UK, PrEP service delivery models for people who inject drugs varied across England and Scotland (and none were identified in Wales and Northern Ireland)
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Harm Reduction Journal

ISSN: 1477-7517