In sub-Saharan Africa(SSA),63%of new human immunodeficiency virus(HIV)infections in 2021 were among women,particularly adolescent girls,and young women.There is a high incidence of HIV among pregnant and lactating wom...In sub-Saharan Africa(SSA),63%of new human immunodeficiency virus(HIV)infections in 2021 were among women,particularly adolescent girls,and young women.There is a high incidence of HIV among pregnant and lactating women(PLW)in SSA.It is estimated that the risk of HIV-acquisition during pregnancy and the postpartum period more than doubles.In this article,we discuss the safety and effectiveness of drugs used for oral HIV pre-exposure prophylaxis(PrEP),considerations for initiating PrEP in PLW,the barriers to initiating and adhering to PrEP among them and suggest recommendations to address these barriers.Tenofovir/emtricitabine,the most widely used combination in SSA,is safe,clinically effective,and cost-effective among PLW.Any PLW who requests PrEP and has no medical contraindications should receive it.PrEP users who are pregnant or lactating may experience barriers to starting and adhering for a variety of reasons,including personal,pill-related,and healthcare facility-related issues.To address the barriers,we recommend an increased provision of information on PrEP to the women and the communities,increasing and/or facilitating access to PrEP among the PLW,and developing strategies to increase adherence.展开更多
文摘In sub-Saharan Africa(SSA),63%of new human immunodeficiency virus(HIV)infections in 2021 were among women,particularly adolescent girls,and young women.There is a high incidence of HIV among pregnant and lactating women(PLW)in SSA.It is estimated that the risk of HIV-acquisition during pregnancy and the postpartum period more than doubles.In this article,we discuss the safety and effectiveness of drugs used for oral HIV pre-exposure prophylaxis(PrEP),considerations for initiating PrEP in PLW,the barriers to initiating and adhering to PrEP among them and suggest recommendations to address these barriers.Tenofovir/emtricitabine,the most widely used combination in SSA,is safe,clinically effective,and cost-effective among PLW.Any PLW who requests PrEP and has no medical contraindications should receive it.PrEP users who are pregnant or lactating may experience barriers to starting and adhering for a variety of reasons,including personal,pill-related,and healthcare facility-related issues.To address the barriers,we recommend an increased provision of information on PrEP to the women and the communities,increasing and/or facilitating access to PrEP among the PLW,and developing strategies to increase adherence.
