Abstract
Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP), the use of antiretroviral medication to prevent HIV acquisition, is a highly effective biomedical prevention tool. The World Health Organization (WHO) recommends PrEP for people at substantial risk of HIV infection, as part of combination prevention, and highlights the need for robust evaluation of PrEP programmes. Based on suggested WHO core indicators, we created a concise set of HIV PrEP-related dataset variables, to harmonise the monitoring and evaluation of PrEP programmes across five closely related nations (England, Northern Ireland, Ireland, Scotland and Wales). The dataset is based on the PrEP cascade and is intended to represent the minimum variables needed for reporting and comparison of meaningful data at national and multinational level. The dataset can be modified for settings with different health and surveillance systems. It is intended for public health, academic, clinical and health planning, and public audiences. Here we describe the dataset and illustrate its use with data from the first year of the Scottish National PrEP programme.
Highlights
Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP), the use of antiretroviral medication to prevent HIV acquisition, is a highly effective biomedical prevention tool
Robust evaluation of PrEP programmes is essential to understanding their effectiveness and place within wider combination prevention strategies
This expert consensus dataset provides a pragmatic means of evaluating core elements of PrEP programmes for ongoing monitoring and inter-country comparison
Summary
To inform the denominators for subsequent variables, an understanding of attendance at these services providing PrEP is required, disaggregated by key sociodemographic variables This measure is not perfect as it is not entirely analogous with PrEP need. We are likely to underestimate the number of people on PrEP within this step because a proportion of individuals will self-source PrEP from the Internet or from private practitioners. Some of these people privately sourcing PrEP will not be attending publicly funded services for any PrEP-related care. Table The PrEP minimum dataset across the proposed measures with data from Scotland’s first year of PrEP implementation, 1 July 2017–30 June 2018 (n =1,874 individuals attending for PrEP)
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