Page 274 - EPREP book

3. Key-Population-Led Health Services (KPLHS) where PrEP service is delivered by

community-based organizations (CBOs). This type of service delivery is available in
some provinces in the country.

In 2020, the National Health Security Office (NHSO) launched a pilot project in providing
PrEP service for 2,000 PrEP initiators in 51 PrEP service centers. In this regard, the national
monitoring and evaluation (M&E) framework has been adopted to evaluate on this early

implementation. As a part of M&E process, this study aims to evaluate the PrEP services under
this UHC pilot project delivered to identify significant gaps and issues concerning PrEP cascade

and reflect “real world” feasibility of PrEP use as well as issues hindering the retention in PrEP
services among key populations. The findings from this evaluation would be crucial to inform
decisions regarding increase coverage in UHC as well as improvement of PrEP service delivery

in Thailand.

1.2 Objectives

1. To assess PrEP service provision and identify pros and cons among the three service

delivery models in PrEP implementation.
2. To compare different characteristics between PrEP users who continued on PrEP for three
or more consecutive months and the broader PrEP-eligible population, and identify factors

affecting PrEP adherence and discontinuation.
3. To explore perceived barriers and facilitators, awareness and interest, and attitude towards
PrEP utilization among PrEP clients as well as risk compensation i.e. increased unsafe sex

among PrEP users, reduced condom use, STIs prevalence.
4. To identify key factors affecting successful PrEP implementation as well as PrEP service
providers’ knowledge of and attitudes towards PrEP service.

2. Methodology

This M&E is a mixed methods study, entailing both quantitative and qualitative analyses. The
study consists of three parts:
1. Secondary data analysis of consecutive PrEP clients from the National AIDs Program

(NAP PLUS) under NHSO for the fiscal year 2020 during the period from 1 October 2019 to 30
September 2020 to capture PrEP cascades, and analyze on Thailand PrEP uptake and retention.

2. A study involving PrEP service providers consisting of 2 parts which are 1.) A self-
administered questionnaire to examine PrEP service providers’ knowledge of and attitudes
towards PrEP service and 2.) A focus group interview using semi-structure questionnaire to

รายงานการประเมินผลการด าเนินงาน PrEP ภายใต้ชุดสิทธิประโยชน์สปสช. ปีงบประมาณ 2563 [211]