Although oral PrEP is highly effective at preventing HIV acquisition, optimizing continuation among beneficiaries is challenging in many settings. We estimated the costs of delivering oral PrEP to populations at risk of HIV in seven clinics in Zimbabwe. Full annual economic costs of oral PrEP initiations and continuation visits were estimated from the providers' perspective for a six-clinic NGO network and one government SGBV clinic in Zimbabwe (January-December 2018). Disaggregating costs of full initiation and incremental follow-up visits enabled modeling of the impact of duration of continuation on the cost per person-year (pPY)onPrEP.4677peopleinitiatedoralPrEP,averaging2.7follow−upvisitsperperson.Averagecostperpersoninitiatedwas238 (183−302 across the NGO clinics; 86inthegovernmentfacility).Thefullcostperinitiationvisit,includingcentralanddirectcosts,was178, and the incremental cost per follow-up visit, capturing only additional resources used directly in the follow up visits, was 22.Theaveragedurationofcontinuationwas3.0 months,generatinganaveragepPY of 943,rangingfrom839 among adolescent girls and young women to 1219inmen.OralPrEPdeliverycostsvariedsubstantiallybyscaleofinitiationsandbydurationofcontinuationandtypeofclinic.ExtendingtheaverageoralPrEPcontinuationfrom2.7to5visits(about6 months)wouldgreatlyimproveserviceefficiency,cuttingthepPY by more than half