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Implementation Research to Inform and Enhance President’s Emergency Plan for AIDS Relief (PEPFAR) Pre-exposure Prophylaxis (PrEP) Delivery


Christopher Gordon, Ph.D.
Division of AIDS Research


The goal of this initiative is to support implementation science research that will inform delivery and scale-up of pre-exposure prophylaxis (PrEP) at President’s Emergency Plan for AIDS Relief (PEPFAR) sites.


PEPFAR is a global health initiative launched in 2003 designed to provide HIV prevention, care, and treatment services in low- and middle-income countries to combat the devastation of HIV/AIDS globally. PEPFAR’s priority to strategically initiate PrEP delivery for people at substantial HIV-risk is a critical opportunity that will be accompanied by challenges, both known and unknown. To optimize implementation, it is recommended that PrEP provision, whenever possible, is accompanied by implementation research to inform and evaluate strategies to best target and deliver PrEP to at-risk populations.

Research foci include but are not limited to:

  • Studies to evaluate PrEP delivery models in varied settings, to optimize PrEP uptake.
  • Studies to evaluate strategies to increase awareness, increase demand for PrEP, and motivate PrEP initiation among those at highest risk for HIV.
  • Studies to identify provider training needs to target PrEP candidates at substantial risk, and to address barriers to adherence and retention in PrEP care that are unique to different at-risk population members.
  • Studies to evaluate brief and scalable PrEP monitoring and adherence support strategies.
  • Studies to evaluate cost and incremental cost-effectiveness studies on different PrEP delivery strategies.
  • Studies to evaluate strategies to reduce the frequency of visits.
  • Studies to examine characteristics of PrEP adopters and decliners, adherence, alignment of PrEP use with risk perception, duration of use, and reasons for discontinuation of PrEP.