Since April 2021, ICAP has supported the rollout of Pre-Exposure Prophylaxis (PrEP) medication in eight key population (KP) group drop-in centers across Sierra Leone. ICAP, in collaboration with selected KP-led civil society organizations, worked to initially enroll 800 KP clients on PrEP between May and September 2021. Instead, ICAP support initiated over 1,300 KP clients on PrEP, exceeding the target.

With funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), through the Department of Health Resources and Services Administration (HRSA), ICAP supported the implementation of PrEP in Sierra Leone as part of the Global Reach II program to achieve sustainable HIV epidemic control around the world.

Samuel Caulker is a peer group navigator at the Dignity Association in Sierra Leone, an organization that advocates for the rights of LGBTQI people. He helps clients navigate treatment options for HIV and has witnessed the power of PrEP in preventing the spread of disease among key populations who visit the Dignity Association drop-in center. “PrEP has proven to be very effective, as 90 percent of the 92 KP clients initiated on PrEP at our drop-in center have remained HIV negative even as they maintain their usual lifestyle,” Caulker said.

KP Testing in a community in Freetown


HIV is one of the most alarming health challenges in Sierra Leone, with over 80,000 people living with the disease. Most HIV infection rates are among key populations, including men who have sex with men, transgender people, sex workers, people who inject drugs, and people in prison or detention. This is where PrEP comes in. The World Health Organization recommends using PrEP medication to help prevent HIV infection, especially among key populations who have an elevated risk of acquiring HIV.

“Stigma and discrimination are significant barriers to health-seeking behaviors among key population groups in Sierra Leone,” said Mame Awa Toure, MD, MSc, ICAP in Sierra Leone’s country director. “Therefore, to successfully implement PrEP, we partnered key population-led drop-in centers where these groups feel safe as a preventive strategy to accelerate HIV epidemic control in the country,” said Toure.

In addition, ICAP also developed PrEP related standard operating procedures, training manuals, and other information, education, and communication materials that the Sierra Leone Ministry of Health and Sanitation has begun incorporating into the country’s national HIV strategic plan.

On Friday, February 11, 2022, ICAP donated 13,390 doses of newly procured PEPFAR-funded PrEP medication to the National AIDS Secretariat in Freetown to continue the provision of PrEP to already initiated KP clients.

With the contribution of ICAP-led PrEP activities in Sierra Leone, the number of people on HIV treatment has increased by over 20 percent since 2021– an essential advancement towards Sierra Leone’s goal of controlling the HIV epidemic by 2030. 

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