Defining gaps in pre-exposure prophylaxis delivery for pregnant and post-partum women in high-burden settings using an implementation science framework
Jillian Pintye, Dvora L Joseph Davey, Anjuli D Wagner, Grace John-Stewart, Rachel Baggaley, Linda-Gail Bekker, Connie Celum, Benjamin H Chi, Thomas J Coates, Allison K Groves, Jessica E Haberer, Renee Heffron, John Kinuthia, Lynn T Matthews, James A McIntyre, Dhayendre Moodley, Lynne M Mofenson, Nelly Mugo, Andrew Mujugira, Landon Myer, Steven Shoptaw, Lynda Stranix-Chibanda, Jared M Baeten, PrEP in Pregnancy Working Group, Jillian Pintye, Dvora L Joseph Davey, Anjuli D Wagner, Grace John-Stewart, Rachel Baggaley, Linda-Gail Bekker, Connie Celum, Benjamin H Chi, Thomas J Coates, Allison K Groves, Jessica E Haberer, Renee Heffron, John Kinuthia, Lynn T Matthews, James A McIntyre, Dhayendre Moodley, Lynne M Mofenson, Nelly Mugo, Andrew Mujugira, Landon Myer, Steven Shoptaw, Lynda Stranix-Chibanda, Jared M Baeten, PrEP in Pregnancy Working Group
Abstract
Pregnancy is a high-risk period for HIV acquisition in African women, and pregnant women who become acutely infected with HIV account for up to a third of vertical HIV transmission cases in African settings. To protect women and eliminate vertical transmission, WHO recommends offering oral pre-exposure prophylaxis (PrEP) based on tenofovir to HIV-negative pregnant and post-partum women with a substantial risk of HIV acquisition. PrEP implementation for pregnant and post-partum women lags behind implementation for other high-risk populations. Unique considerations for PrEP implementation arise during pregnancy and post partum, including the integration of provider training with clinical delivery and monitoring of PrEP exposure and outcomes within existing maternal health systems, yet scarce implementation data are available to generate evidence in this context.
Conflict of interest statement
Disclaimer/conflict of interest: This paper represents the opinions of the authors and is not meant to represent the position or opinions of the organizations, including the World Health Organization, nor the official position of any staff members. Dr. Baeten reports grants from NIH, USAID, BMGF, during the conduct of the study; personal fees from Gilead, Merck, Janssen, outside the submitted work. Dr. Haberer reports personal fees from Merck, outside the submitted work. Dr. John-Stewart reports grants from NIH, grants from PEPFAR, personal fees from UW, during the conduct of the study; grants from NIH, grants from CDC, grants from Thrasher, grants from PEPFAR, personal fees from UpToDate, grants from IMPAACT, personal fees from UW, outside the submitted work. Dr. Matthews reports grants and other from Gilead Sciences, outside the submitted work. Dr. Wagner reports grants from National Institutes of Health, during the conduct of the study.
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Source: PubMed