PrEP continuation (at 3 months)
This indicator measures the continuation of PrEP among people who start PrEP, and it also assesses loss to follow-up.
- Data from some studies indicate that many users who discontinue oral PrEP do so during the first few months.
- This indicator provides a measure of early PrEP discontinuation as well as an indication of the number likely to continue taking PrEP.
- A low percentage of people continuing on PrEP at 3 months should trigger investigation into the reasons that people stopped taking PrEP, and programmes should be revised appropriately.
Number of people who continued on PrEP for 3 consecutive months after having initiated PrEP during the reporting period
Number of people who initiated oral PrEP during the reporting period
For the numerator and denominator. Programme records
People who initiated PrEP include both people who received PrEP for the first time and those who had previously discontinued PrEP and restarted it during the reporting period. Regular PrEP users who are continuing on PrEP should be excluded from both the numerator and denominator. All people who return for the 3-month visit and took PrEP until that time should be counted in the numerator, whether or not they chose to continue with PrEP after the 3-month visit.
The denominator is generated by counting the number of people who initiated oral PrEP during the reporting period (numerator of indicator PR.3) in accordance with national guidelines or WHO/UNAIDS standards. Individuals should be counted in the period in which they initiated PrEP to enable comparisons with the numbers from indicator PR.3 and for consistency across reporting periods.
For event-driven dosing among men who have sex with men, 3-month continuation is defined as reported use of the 4-dose regimen around at-risk exposures over a 3-month period. Continuation for event-driven dosing should not be based on number of pills taken, as this will incorrectly identify these clients as non-continuous. If event-based dosing is recorded in patient records or service registers, efforts must be made to ensure the confidentiality and security of these records, since event-based dosing will identify these clients as men who have sex with men.
The recommended reporting period is 12 months.
- Gender (male, female, transgender)
- Age (15-19, 20-24, 25-49, and 50+)
- Key populations (men who have sex with men, people living in prisons and other closed settings, people who inject drugs, sex workers, transgender people), and adolescent girls and young women
- Dosing (daily oral PrEP, event-driven PrEP (for men who have sex with men)).
WHO Strategic Information Guidelines, 2020 (https://indicatorregistry.unaids.org/sites/default/files/9789240000735-eng.pdf)