Annexure 4: Integrated Visit Schedule for the Mother Taking PrEP
Visit Schedule for Integrated Care: Mother taking PrEP The principles are as follows: Wherever possible, try to align the mother’s PrEP, HIV and STI screening and contraception visits with that of the child’s EPI visit schedule so the mother-baby pair need only attend the facility once for all consultations on the same day Wherever possible, allow the mother and baby to receive care at the same s
Visit Schedule for Integrated Care: Mother taking PrEP
The principles are as follows:
- Wherever possible, try to align the mother’s PrEP, HIV and STI screening and contraception visits with that of the child’s EPI visit schedule so the mother-baby pair need only attend the facility once for all consultations on the same day
- Wherever possible, allow the mother and baby to receive care at the same service point (ideally PNC/MCH) at the same facility
Click on the image to enlarge.
* Mother may have PrEP supply remaining from her last supply during ante-natal care. Provide sufficient PrEP supply to ensure mother has 3 months supply when she leaves the facility after delivery.
** Review and repeat script at 10 weeks (rather than 12 weeks) to align with the RTHB visit schedule. The additional 2 weeks Rx that the mother will have in reserve from delivery will allow for alignment with the 6-month RTHB appointment which usually happens around week 26 (compared to 6 DCs of PrEP which will only provide enough PrEP for 24 weeks).
*** Confirm the mother’s FP method choice. Inform her that the DMPA injection or the combined oral contraceptive pill (COCP) can be repeated 3-monthly, and will align well with her PrEP and well-baby visit schedules. Using the NET-EN 2-monthly injection will require additional visits by the mother, as a 2-monthly repeat injection will not always align with the visit schedule outlined above.
**** As per WHO recommendations18, the repeat injection of DMPA and NET-EN can be given up to 2 weeks early1 The repeat DMPA injection can be given up to 4 weeks late without requiring additional contraceptive protection. The repeat NET-EN injection can be given up to 2 weeks late without requiring additional contraceptive protection.
Click on the image to enlarge.
Abbreviations
| DC | dispensing cycle (PrEP supply 28-days) |
| 3DC | three dispensing cycles of PrEP |
| DMPA | depo medroxyprogesterone acetate (Depo Provera®) |
| MIP | mother-infant-pair |
| MMD | multi-month dispensing |
| 3MMD | MMD, multi-month dispensing for 3 months |
| NET-EN | norethisterone enantate (Nur Isterate®) |
| RTHB | road-to-health booklet |
South African National Department of Health, Guideline for Vertical Transmission Prevention of Communicable Infections, Version 2_August 2023