PrEP in Macedonia: The 2021 Pilot Programme

PrEP was first offered as an HIV prevention service in February 2021, as part of a pilot programme (PrEP-MKD) implemented in partnership between the Association for Support of People Living with HIV – STRONGER TOGETHER Skopje and the University Clinic for Infectious Diseases and Febrile Conditions, and will run through December 2021.

The piloting of the PrEP service has been provided for in the 2021 HIV Prevention Programme (“Programme for the Protection of the Population from the HIV Infection”) of the Republic of North Macedonia, which is implemented in cooperation between the Ministry of Health and several civil society organisations.

The technical assistance in developing the protocol and preparing the pilot programme was provided by the Office of the World Health Organisation and the Alliance for Public Health in Kiev, Ukraine. The co-funding of the pilot programme was secured through the regional project “Sustainability of Services for Key Populations in Eastern Europe and Central Asia” led by the Alliance for Public Health and funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria.

PrEP in the context of sexual health

The PrEP-MKD Pilot Programme offers PrEP as part of a wider package of sexual health services, which also includes screening for sexually transmitted infections. The interested HIV-affected persons can use these services and obtain PrEP fully free of charge, if it is established that PrEP is the right option for them.

The programme has been designed in the form of a research that will tell us how the PrEP services could function within the domestic context and will provide data that can help these services remain available in the future and expand their coverage. It has been planned to include at least 100 persons in the course of the year, however, if the interest exists, more people can get involved.

PrEP services are provided in the HIV Counselling Office at the University Clinic for Infectious Diseases and Febrile Conditions, every Tuesday and Thursday between 14:00 and 18:00 hrs.

What services are provided within the PrEP programme?

The pilot programme participants undergo a standard assessment process to check if PrEP is the right solution for them. If suitability is confirmed, in the course of implementation of this programme, the participants will be receiving a free package of sexual health services, including:

· regular provision of PrEP tablets

· regular HIV testing

· testing for hepatitis B and hepatitis C

· testing for other sexually transmitted infections: syphilis, gonorrhoea and chlamydia

· vaccination against hepatitis B (if the person has no previously developed antibodies)

· regular medical examination

· condoms and lubricants

· counselling and information material for sexual-health-related issues