A Review of HIV Pre-Exposure Prophylaxis: The Female Perspective

Bailey, Jennifer L.; Molino, Suzanne; Vega, Ana D; Badowski, Melissa E

doi:10.1007/s40121-017-0159-9

Cited by 40 publications

(37 citation statements)

References 63 publications

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“…Surprisingly, women did not appear to consider PrEP as a prevention strategy that was more under their control than condoms. Because condom use often requires women to negotiate with partners or otherwise rely on partner initiated behaviours and PrEP is self‐directed and can be administered without partner awareness , we had anticipated that most women would rate PrEP as more in their immediate control than condom use. The most commonly selected response to this item was perceiving more control over condom use.…”

Section: Discussionmentioning

confidence: 99%

Perspectives of US women participating in a candidate PrEP study: adherence, acceptability and future use intentions

et al. 2019

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Introduction Limited data exist on acceptability of candidate pre‐exposure prophylaxis (PrEP) regimens among US women. We evaluated PrEP experiences, attitudes and future use intentions among sexually active women who completed the US‐based HIV Prevention Trials Network 069/AIDS Clinical Trials Group 5305 study. Methods Women participated in the study between March 2013 and November 2015. We analysed computer‐assisted self‐interview (CASI) surveys among 130 women and conducted in‐depth interviews among a subset of 26 women from three sites. Interviews were conducted in mid/late‐2015. Results Most women (57%) reported very good/excellent PrEP adherence on CASI, although 21% acknowledged over‐reporting adherence at least some of the time. Commitment to preventing HIV infection, a sense of ownership of the study, and keeping pills stored in a visible location facilitated adherence. Adherence barriers included “simply forgetting” and being away from home. Most women interviewed did not intend to use PrEP in the future because of lack of perceived need due to their own (as opposed to their partners’) low‐risk behaviour and concerns about affordability – but not because of side effects or other characteristics of the regimens. Conclusions Improving HIV prevention options for US women will require access to affordable PrEP as well as expanding women's understanding of relationship‐ and community‐level factors that increase their risk of acquiring HIV.

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Section: Discussionmentioning

confidence: 99%

Perspectives of US women participating in a candidate PrEP study: adherence, acceptability and future use intentions

et al. 2019

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“…How best to provide sustained PrEP access for HIV negative women in the post-partum period needs consideration, including whether PrEP might be integrated into well-baby services to support convenient access for new mothers. During the programmatic design phase it will be essential that members of these target groups are engaged so that program developers can hear from potential service users about how they would prefer to access PrEP (32). Failing to engage end-users in early planning may fundamentally undermine program success (33).…”

Section: Discussionmentioning

confidence: 99%

Global and national guidance for the use of pre-exposure prophylaxis during peri-conception, pregnancy and breastfeeding

Davies

Heffron

2018

Sex. Health

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Background. Pre-exposure prophylaxis (PrEP) is a well-established biomedical HIV prevention strategy and recommended as a safe strategy to reduce HIV risk during peri-conception, pregnancy and breastfeeding. Efforts are now needed to translate global recommendations into national guidelines and implementation strategies. This article presents the current status of policy guidance for the use of PrEP during periconception, pregnancy and breastfeeding, with a particular focus on high prevalence countries including those in sub-Saharan Africa. Methods. We reviewed and summarized PrEP clinical guidelines released by ministries of health or other national-level health bodies that have authored normative guidelines with a particular focus on recommendations for PrEP use during peri-conception, pregnancy, and/or breastfeeding. Results. Among countries with PrEP guidelines and/or policy, pregnancy is recognized as a period with increased HIV vulnerability and some specifically recommend PrEP use during pregnancy. Only one country specifically notes that PrEP is contraindicated during pregnancy recognizing a gap in complete safety data from women using PrEP throughout pregnancy. PrEP is not contraindicated as a peri-conception HIV prevention strategy in any country but only three countries have specific guidance for peri-conception HIV prevention. Multiple barriers to the implementation of PrEP during pregnancy and breastfeeding are discussed including barriers at the policy, health systems, social, and personal levels. Conclusion. Although pregnancy is a period of heightened risk and fertility rates are high in many settings with high HIV burden, few PrEP policies have included guidance for PrEP use specific to peri-conception, pregnancy and breastfeeding periods. This gap can be overcome by the development or adoption of national clinical guidelines and implementation strategies from exemplary countries.

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“…22,23 This meta-analysis demonstrated that PrEP was effective in preventing HIV infection across sexes, although individual studies consisting of only female participants has been variable. 22,23 The FEM-PrEP and VOICE trial did not find significant difference in effectiveness of PrEP compared to placebo. • A serodiscordinant sex partner • Inconsistent condom use with a partner whose HIV status is unknown and who is at high risk • An STI with syphilis or gonorrhea within the past 6 months" 7, 18 Persons who inject drugs "Have one of the following:…”

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confidence: 98%

“…12 The Partners PrEP study found a 66% reduction of seroconversion in women who used PrEP. 13,22 A meta-analysis validated the effectiveness of PrEP with high adherence (70% of potential HIV cases averted) across various populations and methods of exposure. 22,23 This meta-analysis demonstrated that PrEP was effective in preventing HIV infection across sexes, although individual studies consisting of only female participants has been variable.…”

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confidence: 99%

“…13,22 A meta-analysis validated the effectiveness of PrEP with high adherence (70% of potential HIV cases averted) across various populations and methods of exposure. 22,23 This meta-analysis demonstrated that PrEP was effective in preventing HIV infection across sexes, although individual studies consisting of only female participants has been variable. 22,23 The FEM-PrEP and VOICE trial did not find significant difference in effectiveness of PrEP compared to placebo.…”

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confidence: 99%

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