Resumen
New effective clinical interventions for the control and prevention of HIV infection have been available for some time, however, the process of adopting these innovations have varied in different countries. Peru and Ecuador represent two case studies of Andean countries that have had some trajectory in the implementation of clinical research to evaluate a new HIV prevention technology, pre-exposure prophylaxis (PrEP) that had a successful outcome conducive to the approval of an antiretroviral medication for HIV prevention by the US Food and Drug Administration (FDA). This chapter describes the evolution of the national response to the HIV/AIDS epidemic in both countries with concentrated epidemics in men and transgender women who have sex with men (MSM/TG) and analyzes how health priorities, leadership, political will, cultural factors, financial resources, communication, and access to information affect the adoption of HIV prevention innovations that could make a difference in the epidemic in these countries. Nevertheless, the recent developments in the creation of HIV/AIDS Multisectorial Strategic Plans provide a perfect opportunity to generate a forum for the discussion about the incorporation of these new HIV prevention technologies in future strategies. Several people have contributed to writing this chapter providing time for interviews or facilitating access to sources of information that are not publicly available; however, the final text is the sole responsibility of the authors.