{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:58:59Z","timestamp":1787752739536,"version":"build-2784847793"},"reference-count":14,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["#INV\u2010053199"],"award-info":[{"award-number":["#INV\u2010053199"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["#INV\u2010073717"],"award-info":[{"award-number":["#INV\u2010073717"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Post\u2010exposure prophylaxis (PEP) is an important component of comprehensive HIV prevention, yet its uptake has been suboptimal globally. In July 2024, the World Health Organization (WHO) updated its global guidance on PEP to include two new recommendations intended to increase timely access to and delivery of PEP. These recommendations specifically aim to expand both <jats:italic>where<\/jats:italic> PEP can be delivered, to include community settings, and <jats:italic>who<\/jats:italic> can provide PEP, to include community health workers and task\u2010sharing. The practical realities of adopting new public health guidelines to achieve the intended benefits in most contexts are complex. Articulating these realities is important for identifying what will be required to ensure the feasibility of expanded PEP access in community settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>We provide stakeholder perspectives from five African countries\u2014Kenya, Nigeria, South Africa, Uganda and Zimbabwe\u2014on both barriers to and strategies for implementing the new WHO PEP recommendations. These perspectives are informed by experiences in these countries that were shared at a recent workshop and highlight key themes related to PEP uptake and use: awareness and acceptability; administration and monitoring; policy alignment, including regulatory considerations; logistics; integration of services; stakeholder involvement and capacity building; and linking PEP and PrEP more directly. Running across these themes are the roles of socio\u2010cultural norms and the need for increased resources to pay for implementing the recommendations, including capacity strengthening and monitoring in communities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While significant challenges exist to expanding PEP access in community settings and through task\u2010sharing, there are examples from our countries of successful efforts to mitigate them by leveraging existing community resources and capacities in innovative ways. Additional efforts will require engagement across multiple stakeholders to address remaining awareness gaps, logistical and regulatory obstacles, and political will. As countries work to update their guidelines and align with the new WHO recommendations, continued collaboration and innovation within and across countries will be essential to realize the full potential of PEP in comprehensive HIV prevention efforts.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26447","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T13:11:58Z","timestamp":1750943518000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Implementing the new WHO guidelines on HIV post\u2010exposure prophylaxis: perspectives from five African countries"],"prefix":"10.1002","volume":"28","author":[{"given":"Sarah","family":"Magni","sequence":"first","affiliation":[{"name":"Genesis Analytics  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Byamukama","sequence":"additional","affiliation":[{"name":"HIV Prevention Uganda AIDS Commission  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam Sani","family":"Haske","sequence":"additional","affiliation":[{"name":"Community Prevention and Care Services National Agency for the Control of AIDS  Abuja Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Mukami","sequence":"additional","affiliation":[{"name":"Preventive and Curative Department National Syndemic Disease Control Council  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idah","family":"Moyo","sequence":"additional","affiliation":[{"name":"Ministry of Health and Child Care  Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3508-9888","authenticated-orcid":false,"given":"Judith D.","family":"Auerbach","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"The urgency of now: AIDS at a crossroads","author":"Joint United Nations Program on HIV\/AIDS","year":"2024"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(24)00235-2"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(23)00238-2"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofae332"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.26341"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25942"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2023.2288309"},{"key":"e_1_2_9_9_1","volume-title":"Guidelines for HIV post\u2010exposure prophylaxis","author":"World Health Organization","year":"2024"},{"key":"e_1_2_9_10_1","volume-title":"Guidelines for HIV post\u2010exposure prophylaxis: web annex B: systematic review of findings and GRADE tables","author":"Kennedy C","year":"2024"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.26393"},{"key":"e_1_2_9_12_1","volume-title":"PEP: the forgotten HIV prevention intervention","author":"Insights to Implementation","year":"2024"},{"key":"e_1_2_9_13_1","volume-title":"Synthesis of Post\u2010Exposure Prophylaxis (PEP) Policies in MOSAIC Countries. Brief","author":"MOSAIC","year":"2022"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.26374"},{"key":"e_1_2_9_15_1","unstructured":"MOSAIC.PEP Template Guidelines (English). 6 January 2025. Available from:https:\/\/www.prepwatch.org\/resources\/pep\u2010template\u2010guidelines\u2010english\/. (Accessed 11 February 2025)."}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.26447","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T05:42:26Z","timestamp":1754372546000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.26447"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":14,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1002\/jia2.26447"],"URL":"https:\/\/doi.org\/10.1002\/jia2.26447","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6]]},"assertion":[{"value":"2024-11-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e26447"}}