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- How does PrEP work?
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- Quick Answers: Reference for FAQs during Counselling
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- Everyone
PrEP testing posters (English)
PrEP factsheet for pregnant and breastfeeding women (English)
2024 IEC Materials
Final versions
PrEP is Choice_PrEP Pocket Book_October 2024 v 11
PrEPisChoice_Project PrEP_Palm Card_October 2024 v3
PrEPisChoice_OralPrEP_Posters_October 2024 v2
PrEPisChoice_OralPrEP_Factsheet_October 2024 v3
PrEPisChoice_TestingPosters_June 2024 v2
Project PrEP
PrEPisChoice_Project PrEP_Safeguarding Poster_July 2024 v2
PrEPChoice_PocketBook_SBCC_October 2024 v7
PrEP Continuation
PrEP is Choice_Gift of PrEP_Poster_October 2024 v1
PrEP is Choice_Gift of PrEP_Poster_October 2024 v2
PrEP Side Effects
Project PrEP_Side Effects_October 2024 v5
Self-care
PrEP is Choice_Menstruation_October 2024 v3
PrEP is Choice_PalmCard_Thinking of Sex_October 2024 v3
PrEP is Choice_Relationship brochure_October 2024 v2
PrEP is Choice_Teen pregnancy rights Bookmark_October 2024 v3
PrEP is Choice_Mental Health Bookmark_Novemebr 2024 No print marks v2
STIs
PrEPisChoice_STI_ContraceptionFoldOut_October 2024_No print marks
PrEP is Choice_STI Pocket book_October 2024 v2 No print
Print versions
Oral PrEP
PrEP is Choice_PrEP Pocket Book_October 2024 v 11
PrEPisChoice_OralPrEP_Factsheet_October 2024 v3
PrEPisChoice_OralPrEP_Posters_October 2024 v2
PrEPisChoice_Project PrEP_Palm Card_October 2024 v3
PrEPisChoice_TestingPosters_June 2024 v2
Project PrEP
PrEP is Choice_Outreach Posters_Project PrEP July 2024 v6
PrEPChoice_Palm Card_74x105mm_Apr2024_
PrEPChoice_PocketBook_SBCC_October 2024 v7
PrEPChoice_Poster_A3.2 March 2024 version 1
PrEPisChoice_Project PrEP_Safeguarding Poster_July 2024 v2
Z-fold_TableTalkAdapt_ March v1
PrEP Continuation
PrEP is Choice_Gift of PrEP_Poster_October 2024 v1
PrEP is Choice_Gift of PrEP_Poster_October 2024 v2
PrEP Side Effects
Project PrEP_Side Effects_October 2024 v5
Self-care
PrEP is Choice_Relationship brochure_October 2024
PrEP is Choice_Teen pregnancy rights Bookmark_October 2024 v3
PrEP is Choice_Menstruation_October 2024 v3
PrEP is Choice_PalmCard_Thinking of Sex_October 2024 v3
PrEP is Choice_Mental Health Bookmark_Novemebr 2024 Print marks v2
STIs
PrEPisChoice_STI_ContraceptionFoldOut_October 2024_Print marks
PrEP Initiation Algorithm (A4)
2024
Print versions
PrEP Initiation Algorithm (Pregnant and Breastfeeding Women)
Counselling Job Aid for Healthcare Providers (Pregnant and Breastfeeding Women)
Oral PrEP Counselling Job Aid PBFP [June 2024 (A4)]
Oral PrEP Counselling Job Aid [August 2024 (A4)]
Oral PrEP Guidelines Update [August 2024 (A4)]
Oral PrEP Initiation Algorithm PBFP [August 2024 (A4)]
Oral PrEP Initiation Algorithm [August 2024 (A4)]
Oral PrEP Fact Sheet PrEP PBFP [August 2024 (A5)]
Oral PrEP Factsheet [August 2024 (A5)]
Oral PrEP Clinical Form [August 2024 (A4)]
No print
OralPrEP_InitiationAlgorhithmA4_PrintNoMarks
OralPrEPFactSheetPrEP_PBFP_A5_NoPrintMarks
OralPrEP.FactsheetA5_PrintNoMarks
OralPrEP_ClinicalForm_A4_NoPrintMarks
OralPrEP_CounsellingJobAid_A4_NoPrintMarks
OralPrEP_CounsellingJobAid_PBFP_A4_NoPrintMarks
Currently in South Africa, PrEP is being provided through a limited number of service delivery sites. Use the PrEP finder search for the nearest PrEP clinic.
If your client is on PrEP and they still get HIV their health care provider will do some tests to determine why they seroconverted. It does not necessarily mean that they will be resistant to ARVs (ex: window period, low adherence, infected with TDF resistant virus, etc).
PrEP means taking a pill every day and going for regular HIV testing, NO EXCUSES!
PrEP should be used with other HIV prevention methods.
She must inform her clinician and together they will discuss how to proceed.
If your client decides that they no longer wish to take PrEP, they should discuss stopping with a healthcare provider. They will get information for how long after they should continue to make sure they are properly protected.
If your client misses a pill, they should take it as soon as they remember, and continue to take it daily as before.
PrEP requires strict adherence to daily medication and regular HIV testing. Where possible, it should be used together with other HIV prevention methods.
If it is used properly, PrEP will play a role in helping to reduce the number of new HIV infections in South Africa.
Supporting pill-taking should be honest, direct and non-confrontational.
Steps to follow:
- Assess how pill taking is going for PrEP client
- Positively affirm client to support provider/client relationship
- Identify a motivator to support effective pill taking
- Provide PrEP education regarding effective use and effectiveness of PrEP
- Identify barriers to effective use
- Provide realistic strategies to address barriers
- Discuss use of other HIV prevention measures that are relevant to situation
- Ensure client leaves with realistic and achievable plan to increase or sustain use
Adherence means taking the PrEP pill every day.
Suggest methods to remind the client to take the pill every day.
For example:
- Take the pill at the same time every day
- Incorporate it into your daily activities, like part of your morning routine or when a favourite TV show comes on
- Set a phone alarm
- Use daily pillboxes
Daily PrEP can be taken with alcohol, drugs or contraception. It does not react negatively with any normal day to day activity.
Discuss what to do if a pill is missed – take it as soon as client remembers.
Follow-up sessions will most likely be brief. It is critical to review adherence during these discussions and re-evaluate the client’s risk profile if he or she has experienced lifestyle changes. Please ensure you use your organisation’s available counselling tools for each of these topics.
Re-assess the client’s risk profile
Discuss any lifestyle changes that may affect the suitability of PrEP use.
Combination prevention
Touch base with the client’s sexual health plan and make sure they have access to other prevention resources, as appropriate.
STIs
PrEP does not protect against STIs. Regular testing for STIs is encouraged, regardless of PrEP use. IMPORTANT: If your client presents with an STI, they will need additional counselling.
Contraception / Fertility goals
PrEP is not a contraceptive. PrEP is safe to use with all contraceptive methods. Consult with a physician to provide guidance on how to proceed if the client becomes pregnant.
Adherence (daily)*
For PrEP to be effective, the pill must be taken every day. Adherence counselling is critical for full HIV protection. *More detail is provided in the Adherence section that follows.
Side effects
Touch base about the client’s experience with side effects.
REMEMBER: If side effects are serious, please involve a doctor with your client’s care.
Intimate partner violence (IPV)
People who have abusive or controlling partners may find it more difficult to take care of their sexual health and to adhere to PrEP. Ask about the client’s relationships, and for clients experiencing abuse, provide counselling and referrals, when possible.
Talking to your partner, family, friends, etc.
Deciding whether to tell anyone about your PrEP use is a completely personal decision. Some people find it helpful to tell friends or family for support and to provide reminders to take the pill daily. Discuss with the client whether and how they would like to discuss PrEP with loved ones and how to overcome any potential barriers to gaining their support.
Visit schedule
Explain the visit schedule for PrEP use. The client must return for follow-up visits at the first month, and then every three months. They must also return to the clinic monthly to pick up their pills.
This is a list of important topics to discuss with the client when explaining PrEP for the first time and deciding whether it might be right for him or her. It is not comprehensive. Please ensure you use your organisation’s available counselling tools for each of these topics.
What to discuss:
Assess the client’s risk profile
How to discuss it:
Develop a clear picture of the client’s risk profile and lifestyle; make sure they understand how their lifestyle impacts their risk profile. IMPORTANT: use your organisation’s risk assessment tools.
What to discuss:
Combination prevention
How to discuss it:
Taken daily, PrEP is an additional prevention option. It should be used in combination with other prevention tools, like condoms, PEP, healthy lifestyles, treatment for STIs, male medical circumcision, and ART for partners living with HIV. REMEMBER: counselling should highlight that ideally PrEP should be used with condoms.
- Sensitive, inclusive, and non-judgmental
Recognize that behaviour change is difficult and human beings are not perfect - Presented as a personal choice
Counselling should support the client in making a personal choice based on their needs and desires. - Problem solve and foster motivation
Offer choices and tangible solutions; identify small wins and achievable next steps in reducing risk. - Client-driven and based on their needs, resources, and preferences
Counselling should be interactive and tailored to the client’s specific needs and lifestyle. - Brief
10-15 minute check-ins about experience with PrEP and sexual health protection plans are most effective; longer (~30 minute) sessions may be necessary at the first PrEP consultation or if specific issues arise.