Lynn T Matthews, Katia J Bruxvoort, Manjeetha Jaggernath, Yolandie Kriel, Patricia M Smith, Jessica E Haberer, John Bassler, Kara Bennett, Christina Psaros, David R Bangsberg, Kathleen Wirth Hurwitz, Jennifer A Smit
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引用次数: 0
Abstract
Objective: We developed Healthy Families-PrEP to support perinatal women to use HIV prevention strategies.
Design: Single arm study to evaluate PrEP use among pregnant women exposed to the intervention.
Methods: We offered safer conception counselling including TDF/FTC as PrEP with adherence support (Healthy Families-PrEP) for women planning for pregnancy in South Africa with a partner with HIV or unknown serostatus. Women completed pregnancy and HIV testing quarterly and were followed for one year or until pregnancy end. For those initiating PrEP, electronic pillcap data and plasma were collected. We described PrEP adherence by proportion of days with pillcap openings and proportion of women with detected (≥10ng/mL) plasma tenofovir.
Results: From November 2017 to January 2020, 326 women with median age 24 (IQR: 22-27) years enrolled. Partner HIV-serostatus was unknown by 316 (97%). Over 3,204 person-months of follow-up, 56 women became pregnant. Twenty-six women used PrEP during pregnancy and opened pillcaps on a mean of 53.1% (95% CI 46.9-59.3%) of days. Plasma tenofovir was detected among 25.0%, 15.4%, and 12.5% of women providing samples during months 0-3, 4-6, and 7-9. No HIV seroconversions were observed.
Conclusions: We observed low pregnancy incidence. Counselling may have encouraged delayed pregnancy plans; some women may have exaggerated pregnancy plans to enroll. About half of pregnant women used PrEP and took over half of doses by pillcap. Fewer than 25% had tenofovir detected, likely reflecting pregnancy-related pharmacokinetics and adherence challenges. High interest in pregnancy PrEP use highlights the need to optimize adherence support and prevention choice.
期刊介绍:
Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.