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

Export Indicator

Number of individuals who have been newly enrolled on 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.
Rationale
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, FSW, and transgender people (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 person-years.
Numerator

Number of individuals who have received (oral) antiretroviral pre-exposure prophylaxis (PrEP) to prevent HIV infection

Denominator

N/A

Calculation

How to calculate annual total:

Sum results across quarters.

Method of measurement
How to collect:
 
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.
 
Reporting of the key population disaggregation should be consistent with what is described under the KP_PREV “How to review for data quality” section on mutual exclusivity of an individual who falls under multiple KP categories (e.g., FSW who injects drugs). In such instances, the individual should only be reported in ONE KP disaggregation category with which this person is most identified. See Appendix A to support the identification of key populations at service delivery.
 
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. Both KP-specific and clinical partners have the option to complete these KP disaggregation, but only if safe to maintain these files and to report.
 

How to review for data quality:

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:

Facility

Measurement frequency

Reporting frequency:

Semi-Annually

Disaggregation

Numerator Disaggregations:

Disaggregate Groups:

Age/Sex [Required]
 
Disaggregates:
 
• 15-19 F/M, 20-24 F/M, 25-29 F/M, 30-34 F/M, 35-39 F/M, 40-44 F/M, 45-49 F/M, 50+ F/M, Unknown Age F/M
 
Disaggregate Groups:
 
Key Population Type: [Optional]
 
Disaggregates:
 
• People who inject drugs (PWID)
• Men who have sex with men (MSM)
• Transgender people (TG)
• Female sex workers (FSW)
• People in prison and other closed settings
 
 
Denominator Disaggregations:
 
Disaggregate Groups:
 
N/A
 
Disaggregates:
 
N/A
 
 
Disaggregate descriptions & definitions:
 
Age Description: 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.

 

Explanation of the numerator

The numerator is generated by counting the number of people newly enrolled in oral PrEP (including WHO specified regimens “tenofovir-containing 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

Indicator changes (MER 2.0 v2.2 to v2.3):

• Age/sex disaggregates updated.
• KP disaggregations updated to align with other KP-related indicators.
 

PEPFAR Support definition: 

Standard definition of DSD and TA used.
 
Provision of key staff or commodities for PrEP services includes: 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
 
 
Guiding narrative questions:
 
1. Roughly what proportion of those offered PrEP at the site agrees to start PrEP?
2. Of those initiating PrEP, how many are estimated to continue at one and three months?
3. What strategy is used to determine PrEP eligibility at the site:
a. Screening tool?
b. All clients considered at risk and eligible?
c. Client request?