Dataset Information

HIV pre-exposure prophylaxis initiation, persistence, and adherence during pregnancy through the postpartum period.

ABSTRACT:

Objective

We evaluated pre-exposure prophylaxis (PrEP) initiation, persistence, and adherence measured via tenofovir-diphosphate (TFV-DP) concentrations in dried blood spots (DBS) among women offered PrEP during pregnancy.

Methods

We prospectively analyzed data from participants in the PrIMA Study (NCT03070600) who were offered PrEP during the second trimester and followed through 9 months postpartum. At follow-up visits (monthly in pregnancy; 6 weeks, 6 months, 9 months postpartum), self-reported PrEP use was assessed, and DBS were collected for quantifying TFV-DP concentrations.

Results

In total, 2949 participants were included in the analysis. At enrollment, median age was 24 years [interquartile range IQR) 21-29], gestational age 24 weeks (IQR 20-28), and 4% had a known partner living with HIV. Overall, 405 (14%) participants initiated PrEP in pregnancy with higher frequency among those with risk factors for HIV acquisition, including >2 lifetime sexual partners, syphilis during pregnancy, forced sex, and intimate partner violence ( P < 0.05). At 9 months postpartum, 58% of PrEP initiators persisted with PrEP use, of which 54% self-reported not missing any PrEP pills in the last 30 days. Among DBS randomly selected from visits where participants persisted with PrEP ( n = 427), 50% had quantifiable TFV-DP. Quantifiable TFV-DP was twice as likely in pregnancy than postpartum [adjusted risk ratio (aRR) = 1.90, 95% confidence interval (CI) 1.40-2.57, P < 0.001]. Having a partner known to be living with HIV was the strongest predictor of PrEP initiation, persistence, and quantifiable TFV-DP ( P < 0.001).

Conclusions

PrEP persistence and adherence waned postpartum, though over half of PrEP initiators persisted through 9-months postpartum. Interventions should prioritize increasing knowledge of partner HIV status and sustaining adherence in the postpartum period.

SUBMITTER: Pintye J

PROVIDER: S-EPMC10527305 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Publications

HIV pre-exposure prophylaxis initiation, persistence, and adherence during pregnancy through the postpartum period.

Pintye Jillian J Kinuthia John J Abuna Felix F Anderson Peter L PL Dettinger Julia C JC Gomez Laurén L Haberer Jessica E JE Marwa Mary M MM Ngumbau Nancy N Omondi Pascal P Odhiambo Ben B Stern Joshua J Watoyi Salphine S Baeten Jared M JM John-Stewart Grace G

AIDS (London, England) 20230606 11

<h4>Objective</h4>We evaluated pre-exposure prophylaxis (PrEP) initiation, persistence, and adherence measured via tenofovir-diphosphate (TFV-DP) concentrations in dried blood spots (DBS) among women offered PrEP during pregnancy.<h4>Methods</h4>We prospectively analyzed data from participants in the PrIMA Study (NCT03070600) who were offered PrEP during the second trimester and followed through 9 months postpartum. At follow-up visits (monthly in pregnancy; 6 weeks, 6 months, 9 months postpartu ...[more]

PMID: 37289583

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Dataset Information

HIV pre-exposure prophylaxis initiation, persistence, and adherence during pregnancy through the postpartum period.

Objective

Methods

Results

Conclusions

Publications

HIV pre-exposure prophylaxis initiation, persistence, and adherence during pregnancy through the postpartum period.

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