Defining the HIV pre-exposure prophylaxis care continuum

Amy S. Nunn, Lauren Brinkley-Rubinstein, Catherine E. Oldenburg, Kenneth H. Mayer, Matthew Mimiaga, Rupa Patel, Philip A. Chan

Research output: Contribution to journalReview articlepeer-review

232 Scopus citations


Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy. There is little scientific consensus about how to measure PrEP program implementation progress. We draw on several years of experience in implementing PrEP programs and propose a PrEP continuum of care that includes: (1) identifying individuals at highest risk for contracting HIV, (2) increasing HIV risk awareness among those individuals, (3) enhancing PrEP awareness, (4) facilitating PrEP access, (5) linking to PrEP care, (6) prescribing PrEP, (7) initiating PrEP, (8) adhering to PrEP, and (9) retaining individuals in PrEP care. We also propose four distinct categories of PrEP retention in care that include being: (1) indicated for PrEP and retained in PrEP care, (2) indicated for PrEP and not retained in PrEP care, (3) no longer indicated for PrEP, and (4) lost to follow-up for PrEP care. This continuum of PrEP care creates a framework that researchers and practitioners can use to measure PrEP awareness, uptake, adherence, and retention. Understanding each point along the proposed continuum of PrEP care is critical for developing effective PrEP interventions and for measuring public health progress in PrEP program implementation.

Original languageEnglish
Pages (from-to)731-734
Number of pages4
Issue number5
StatePublished - Mar 13 2017


  • HIV prevention
  • linkage to care
  • pre-exposure prophylaxis
  • retention in care


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