Pre-Exposure Prophylaxis (PrEP)

Pre-Exposure Prophylaxis (PrEP) is the use of antiretroviral drugs (ARVs) by people who do not have HIV infection in order to prevent the acquisition of HIV.

WHO recommends that oral PrEP containing tenofovir disoproxil fumarate (TDF) should be offered as an additional prevention choice for people at substantial risk of HIV infection as part of combination HIV approaches.

These populations include Men who have Sex with Men (MSM), Female Sex Workers (FSW), People Who Inject Drugs (PWID), and discordant couples. However, PrEP should not replace or compete with effective and well-established HIV prevention interventions, such as comprehensive condom programming for sex workers and men who have sex with men and harm reduction for people who inject drugs.

PrEP Target Populations

The target population for PrEP in Zanzibar currently include the following

PrEP Eligibility Criteria


Having a substantial risk of HIV acquisition, defined as engaging in one or more of the following activities within the last six months:

Clients Ineligible for PrEP

Preferred ARV PrEP regimens

The recommended PrEP regimen is Emtricitabine (FTC) 200mg/Tenofovir Disoproxil Fumarate (TDF) 300mg (Truvada) taken orally once daily.

Indications for PrEP Discontinuation

Individuals taking PrEP require an ongoing risk assessment, and PrEP can be discontinued if individuals acquire HIV infection, are no longer substantial risk for HIV infection or decide to use other effective prevention methods or poor adherence or severe side effects/adverse events.

Note: PrEP should be provided for at least 28 days after the last possible exposure to HIV.

PrEP Service Delivery Modality

PrEP can be provided both at health facilities or MOH-approved community locations/hotspots. PrEP should be provided as part of a comprehensive prevention package of interventions.

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