Abstract:
Background: HIV/AIDS has already become one of the most serious threats to human life. In
2020, an estimated 37.7 million people were infected with the human immunodeficiency virus, with a global adult HIV prevalence of 0.7 percent. Female sex workers are at an extremely high
risk of contracting the human immunodeficiency virus both globally and in Africa. HIV
prevalence in Ethiopia is 0.9% and disproportionately af ects women, with a prevalence of
1.22% compared to 0.64% among males. Pre-exposure prophylaxis has emerged as an ef icient
method of preventing human immunodeficiency virus infection in high-risk populations, particularly female sex workers and sero-discordant couples. Objective: To Evaluate Implementation Fidelity of Oral Pre-Exposure Prophylaxis Service in
Public Health Facilities of Jimma Town, Oromia Regional State, Southwest Ethiopia,2021. Methods: A case study design with mixed methods was employed with the dimensions of
Availability, Adherence and client satisfaction with a total of 46 indicators across the dimensions. A total of 333 exit interviews were conducted. Similarly, a document review of 365 clients' files, 17 in-depth interviews, and a resource inventory were conducted. Quantitative data were entered
into Epi-Data (V4.0.64) and exported to SPSS (V26), and descriptive analyses were done by
using frequency and percentages, while the qualitative data was transcribed, translated, summarized, and categorized into key thematic areas and was presented to complement the
quantitative findings. Finally, the result of this evaluation was interpreted based on pre- determined judgment parameters (>=85 high, 75-84.9 medium, 60-74.9 low, and <=59.9 poor). Results: The evaluation revealed that the overall level of fidelity of implementation in public
health facilities in Jimma Town was low (68.75%) as per the predetermined set of criteria. The
availability of resources required to provide oral PrEP services was medium (78.6%). Provider
adherence to the national implementation manual was low (69.4%), and client Satisfaction with
the oral PrEP service of ered was Poor Level (55.9%). Conclusion: The overall level of implementation fidelity of the oral PrEP service in public
health facilities was poor. Providers should comply with the implementation manual and
refresher training, and the implementation manual, IEC/BCC materials, and STI test kit should
be available
