This updated brief summarizes the most recent evidence on Adolescent Girls and Young Women (AGYW)/Pre-Exposure Prophylaxis (PrEP) provision, serving as a supplement to the original 2021 implementation brief. Evidence was drawn from a review of over 40 resources published in 2022-2024, including academic literature as well as briefs and tools developed by implementers.

Considering these developments in the PrEP landscape – a significant evolution, three years since the original brief was released, both in scale and variety. Global PrEP provision has grown rapidly, from fewer than two million cumulative PrEP initiations to over 6.5 million. In addition, in several countries across ESA, AGYW now have a choice of two or more PrEP options, including tenofovir disoproxil fumarate-based daily oral PrEP (TDF combined with either emtricitabine (FTC) or lamivudine), the monthly dapivirine vaginal ring (DVR), and two-month injectable cabotegravir (CAB) for PrEP. Additional options, including six-month injectable lenacapavir (LEN), the dual prevention pill (DPP) which combines oral PrEP and oral contraception, tenofovir alafenamide-based oral PrEP (FTC/TAF), and a three-month DVR, are also in late-stage development and may become available as early as 2025.

This brief informs the scale-up of PrEP amongst AGYW in Eastern and Southern Africa.