Defining gaps in pre-exposure prophylaxis delivery for pregnant and post-partum women in high-burden settings using an implementation science framework. Issue 8 (August 2020)

• Record Type: Journal Article
• Authors: Pintye, Jillian; Davey, Dvora L Joseph; Wagner, Anjuli D; John-Stewart, Grace; Baggaley, Rachel; Bekker, Linda-Gail; Celum, Connie; Chi, Benjamin H; Coates, Thomas J; Groves, Allison K; Haberer, Jessica E; Heffron, Renee; Kinuthia, John; Matthews, Lynn T; McIntyre, James A; Moodley, Dhayendre; Mofenson, Lynne M; Mugo, Nelly; Mujugira, Andrew; Myer, Landon; Shoptaw, Steven; Stranix-Chibanda, Lynda; Baeten, Jared M
• Is Part Of: Lancet. Volume 7:Issue 8(2020)
• Page Start: e582
• Page End: e592
• Publication Date: 2020-08
• Subjects: HIV (Viruses) -- Periodicals; HIV infections -- Periodicals; AIDS (Disease) -- Periodicals; 616.9792
• DOI: 10.1016/S2352-3018(20)30102-8
• Languages: English
• ISSNs: 2405-4704

Abstract

Summary: 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.