“Treatment as prevention” and similar frameworks reinforce the fact that all steps of the cascade are linked and should be treated as such. As an extension of our existing work in community-led advocacy for HIV treatment, ITPC has developed and implemented innovative community-led demand creation solutions for access to and use of oral pre-exposure prophylaxis (PrEP) for HIV by key populations.
The World Health Organization (WHO) recommends that oral PrEP be offered to people who are HIV negative and at increased risk of HIV infection, in addition to and in combination with other HIV prevention services, such as condoms, male circumcision, antiretrovirals (ARVs) for people living with HIV and drug harm reduction services.
People who need PrEP have a right to access it as a human right to health. Governments have a duty to progressively enable access to PrEP for those in need. According to the standards of health rights, PrEP should be progressively made available, affordable and accessible, and be offered in a manner that is appropriate to the needs and responsive to the concerns of the communities to which it is delivered.
Community-led demand efforts, whether PrEP services are widely available or not at all, can influence the success of PrEP programming, including influencing how accessible PrEP services are to the community, whether people actually choose to take PrEP, and whether these services are being offered in a way that is suited to the needs of PrEP users.
In 2017, supported by the USAID- and PEPFAR-funded LINKAGES project and M∙A∙C AIDS Fund, ITPC conducted a preliminary literature review of global community perspectives on PrEP, hosting the Community-led Consultative Think Tank Meeting on PrEP, articulating key PrEP messages by key population networks and PrEP experts in a policy statement, and the developing the Key Population Activist Toolkit on PrEP.