(PrEP_NEW ) Number of individuals who have been newly enrolled on (oral) antiretroviral pre-exposure prophylaxis (PrEP) to prevent HIV infection in the reporting period.

Export Indicator

Number of individuals who have been newly enrolled on (oral) antiretroviral pre-exposure prophylaxis (PrEP) to prevent HIV infection in the reporting period.
What it measures

The indicator measures the ongoing growth of PrEP services. This measure is critical to assess progress in the program’s response to the epidemic in specific geographic areas, and the uptake and utility of PrEP among persons at substantially increased risk of HIV infection.

This indicator permits monitoring trends in use, but does not attempt to distinguish between different modes or regimens of PrEP or to measure the cost, quality or effectiveness of PrEP provided. These will each vary within and between countries and are liable to change over time.

PrEP has been shown to reduce incident infections among several populations including serodiscordant heterosexual couples, MSM, PWID, and transgender (TG). The WHO now recommends that oral PrEP containing tenofovir should be offered as an additional prevention choice for people at substantial risk, defined as HIV incidence > 3/100 personyears.

Numerator

Number of individuals who have received (oral) antiretroviral preexposure prophylaxis in the reporting period (PrEP) to prevent HIV infection.

Denominator

N/A

Calculation

Sum across quarters

Method of measurement

The numerator can be generated by counting the number of people who are newly enrolled on PrEP in the reporting period, in accordance with national guidelines (or WHO/UNAIDS standards).

NEW is a state defined by an individual’s beginning in a PrEP program. It is expected that the characteristics of new clients are recorded at the time they newly initiate into a program.

Patients are “new” on PrEP only if they are naive to antiretroviral therapy for prevention of HIV infection and have not received oral or topical prophylaxis previously in any program.

Key population disaggregation* see Appendix 1 to support the identification of key populations at ART initiation; If a patient identifies as more than one of the KPs, please enter in all of those that are relevant (therefore KP disaggregations can equal more than the total).

NOTE: In accordance to PREP guidance, not all PREP beneficiaries are expected to fall within the KP disaggregates, therefore the total disaggregations for KP does not have to sum to the numerator total. As well, if a PREP beneficiary identifies as more than one KP, then the individual should be added to both disaggregations, therefore the KP disaggregations, could be more than the total numerator.

NOTE: both KP-specific and clinical partners have the option to complete these disagg, but only if safe to maintain these files and to report.

How to review for data quality:

Sum across quarters

Numerator ≥ subtotal of the age/sex disaggregation: The total number people newly enrolled on PrEP (numerator) should be greater or equal to the subtotal of the age/sex disaggregate group.

Reporting level Site level:

Facility only

Measurement frequency

Quarterly

Disaggregation

Numerator

Number of individuals who have received antiretroviral preexposure prophylaxis in the reporting period (PrEP) to prevent HIV infection

Age/Sex

(15-19 M, 15- 19 F, 20-24 M, 20-24 F, 25-49 M, 25-49 F, 50+ M, 50+ F )

Key population

MSM, Transgender (TG), Female Sex worker(FSW)

Description of Disaggregate

Age is defined as the age at the time of initiation of PrEP. For example, if a 19 year old woman begins PrEP and then shortly after turns age 20, she will still be counted under NEW in the 15-19 F age/sex category.

At the time of initiating PREP, did the patient identify as one or more of the following key populations (if more than one, please add individual to both KP disaggregation):

MSM: Men who have sex with men. A male that has sex with men or both and women

TG: Person who identifies as transgender. Transgender (male to) female: individual was born a boy, but identifies as a woman: Transgender (female to) male: client was born a girl, but identifies as a man

FSW: Female Sex worker. A person whose main source (includes both monetary and non-monetary) of income comes from sex work.

Explanation of the numerator

The numerator is generated by counting the number of people newly enrolled in oral PrEP (including WHO specified regimens “tenofovircontaining PrEP” which could be TDF alone, TDF/FTC, or TDF/3TC) during the reporting period, in accordance with the demonstration project guidance or the nationally approved protocol (or WHO/UNAIDS standards).

Explanation of the denominator

N/A

Further information

MER 1.0 to 2.0 Change :

PrEP_NEW is now reported across PEPFAR programs. It is no longer a DREAMS-specific indicator. There will no longer be a denominator collected for PrEP_NEW. Three KP disaggregations were added.

PEPFAR Support definition

Standard definition of DSD and TA used

Provision of key staff or commodities for PREP services include: ongoing procurement of critical commodities such “tenofovir-containing PrEP” which could be TDF alone, TDF/FTC, or TDF/3TC or funding for salaries of personnel providing any of the prevention package components (i.e. clinicians, outreach workers, program managers). Staff responsible for the completeness and quality of routine patient records (paper or electronic) can be counted here; however, staff who exclusively fulfill MOH and donor reporting requirements cannot be counted.

Ongoing support for HIV prevention among PREP services includes: mentoring and supportive supervision; training; organizational strengthening; QA/QI; program design like development of training curricula, PREP guidance development, or standard operating procedures (SOPs) and follow-up to ensure quality of care; regular assistance with monitoring and evaluation functions and data quality assessments; or supply chain management

DREAMS SNU Specific Guidance: None