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Now a decade since oral pre-exposure prophylaxis (oral PrEP) was shown to be efficacious, results from the SEARCH and ECHO studies have demonstrated that modest rates of PrEP coverage can reduce the HIV infections among PrEP users. Yet until recently, PrEP continuation was viewed through a narrow, ART-influenced definition of adherence, leading some stakeholders to question the effectiveness of PrEP programs. Patterns of PrEP use are better documented and stopping and restarting PrEP is common as individuals align use with seasons of risk. But monitoring effective use of PrEP is challenging because patterns of use vary according to individual needs and life circumstances – some will need PrEP daily, intermittently or for the longer-term. Continuation data (both cross-sectional and longitudinal) provides important information to target interventions with the end goal of improving current and future PrEP delivery, client engagement and quality of care. Tracking continuation at the individual level can help to normalize PrEP use and HIV testing and inform program improvement, while monitoring volume distributed or PrEP coverage can be used to forecast epidemic impact; both are needed. Ultimately, defining and measuring the success of current PrEP programs will set the stage for assessing the impact of HIV biomedical prevention products in the pipeline.
In this session, we will: 1) present key considerations when measuring impact and defining effective use in the context of PrEP; 2) explore approaches programs have developed to measure continued use taking into account variations in risk; and 3) discuss promising practices that support and improve effective use, including support for PrEP users to continue during periods of risk or through method switching, and restarting PrEP after stopping. The session will conclude with thoughts on how these approaches can be applied to next generation HIV biomedical interventions as they become available.

SA05.01 What is effective PrEP use and why does it matter? Jessica Rodrigues, AVAC
Jessica RODRIGUES, AVAC, United States
SA05.02 PrEP uptake, engagement, and impact after population-level HIV testing in rural Kenya and Uganda
Catherine KOSS, UCSF, United States
James AYIEKO, UCSF, Kenya
SA05.03 Measures that Matter: Using M&E to Answer Meaningful PrEP (and HIV Prevention ) Questions
Jason REED, Jhpiego, United States
SA05.04 Key population-led PrEP service: scale-up, adaptability and sustainability
Nittaya PHANUPHAK, Institute of HIV Research and Innovation, Thailand
SA05.05 The mHealth Revolution: Harnessing Mobile Technologies to Support PrEP Use
Albert LIU, San Francisco Health Department, United States
SA05.06 Moderated Q&A
SA05.07 Moderated Panel Discussion
Wanjiru MUKOMA, AVAC, Kenya
Sindy MATSE, Ministry of Health, Eswatini
Amy CHUNG, The Peter Doherty Institute for Infection and Immunity, Australia
Rachel BAGGALEY, World Health Organization, Switzerland
Daniel WERE, Jphiego, Kenya
Sarit GOLUB, Hunter College, United States
SA05.08 Closing Remarks
Robyn EAKLE, USAID, United States
Annika NIEHRS, German Center for Infection Research, Germany