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We use examples from HIV treatment and contraceptives to discuss expectations for PrEP uptake, adherence, and persistence and their combined impact on the epidemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Targets for PrEP uptake must be based on the local HIV epidemic and will depend on appropriate estimates of the key populations at risk for HIV. However, there is evidence that targets, once established, can successfully be met and that uptake may increase with awareness. Messaging around adherence should include that daily adherence is the goal (except for those MSM for whom event\u2010driven dosing is a good fit), but perfect adherence should not be a barrier. Ideally, clients persist on PrEP for as long as they are at risk for HIV. While PrEP will be most effective when coverage is focused on high\u2010risk populations, normalizing rather than stigmatizing PrEP will be highly beneficial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While many challenges to PrEP implementation exist, we focused on the three key steps of uptake, adherence and persistence as measurable processes that can lead to improved coverage and decreased HIV incidence.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25370","type":"journal-article","created":{"date-parts":[[2019,8,28]],"date-time":"2019-08-28T08:43:03Z","timestamp":1566981783000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["Global implementation of PrEP for HIV prevention: setting expectations for impact"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1783-0943","authenticated-orcid":false,"given":"Maria N","family":"Pyra","sequence":"first","affiliation":[{"name":"Department of Global Health University of Washington Seattle WA USA"},{"name":"Department of Epidemiology University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5845-3190","authenticated-orcid":false,"given":"Jessica E","family":"Haberer","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Global Health Boston MA USA"},{"name":"Department of Medicine Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Hasen","sequence":"additional","affiliation":[{"name":"PSI Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Reed","sequence":"additional","affiliation":[{"name":"Jhpiego Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelly R","family":"Mugo","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington Seattle WA USA"},{"name":"Kenya Medical Research Institute (KEMRI) Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8242-8438","authenticated-orcid":false,"given":"Jared M","family":"Baeten","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington Seattle WA USA"},{"name":"Department of Epidemiology University of Washington Seattle WA USA"},{"name":"Department of Medicine University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,28]]},"reference":[{"issue":"222","key":"e_1_2_7_2_1","article-title":"Use of a vaginal ring containing dapivirine for HIV\u20101 prevention in women","volume":"375","author":"Baeten JM","year":"2016","journal-title":"N Engl J Med"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602046"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1108524"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1011205"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.359.6381.1205"},{"key":"e_1_2_7_7_1","unstructured":"Global HIV & AIDS statistics \u2014 2018 fact sheet[Internet].UNAIDS; [cited 2019 May 30]. 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