Challenges and opportunities in HIV pre-exposure prophylaxis use among women globally: A systematic review
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Abstract
Prevalence of HIV/AIDS remains high worldwide. Pre-exposure prophylaxis or PrEP is the use of an antiretroviral medication by HIV-negative people to reduce the risk of HIV acquisition. Ths systematic review aimed to analyse chalenge of hiv pre-exposure prophylactic use in low risk population. We conducted a search from the Scopus, Google Scholar, Science Directory and PubMed data bases. A total of 200 articles met the specified keywords, namely HIV, PreP, woman. In conclusion, PrEP is a highly effective HIV prevention tool for women when used consistently and as directed. Adherence, along with addressing behavioral, biological, and social factors, plays a crucial role in its effectiveness. Adherence to PrEP among women is influenced by a combination of factors related to healthcare access, support systems, individual perceptions, and daily routines. By addressing these factors and providing comprehensive support, healthcare providers can help maximize the effectiveness of PrEP in preventing HIV infection among women at risk. While HIV PrEP is highly effective when used correctly, the risk of drug resistance underscores the importance of regular monitoring, adherence support, and comprehensive counseling to maximize its effectiveness in HIV prevention efforts.
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How to Cite
Pradnyawati, L. G., Wirawan, A. and Januraga, P. P. (2025) “Challenges and opportunities in HIV pre-exposure prophylaxis use among women globally: A systematic review”, Science Midwifery, 12(6), pp. 1986-1997. doi: 10.35335/midwifery.v12i6.1832.
References
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Bekker, L.-G., Roux, S., Sebastien, E., Yola, N., Amico, K. R., Hughes, J. P., Marzinke, M. A., Hendrix, C. W., Anderson, P. L., & Elharrar, V. (2018). Daily and non-daily pre-exposure prophylaxis in African women (HPTN 067/ADAPT Cape Town Trial): a randomised, open-label, phase 2 trial. The Lancet HIV, 5(2), e68–e78.
Beymer, M. R., DeVost, M. A., Weiss, R. E., Dierst-Davies, R., Shover, C. L., Landovitz, R. J., Beniasians, C., Talan, A. J., Flynn, R. P., & Krysiak, R. (2018). Does HIV pre-exposure prophylaxis use lead to a higher incidence of sexually transmitted infections? A case-crossover study of men who have sex with men in Los Angeles, California. Sexually Transmitted Infections, 94(6), 457–462.
Cáceres, C. F., Koechlin, F., Goicochea, P., Sow, P., O’Reilly, K. R., Mayer, K. H., & Godfrey‐Faussett, P. (2015). The promises and challenges of pre‐exposure prophylaxis as part of the emerging paradigm of combination HIV prevention. Journal of the International AIDS Society, 18, 19949.
Calabrese, S. K., Magnus, M., Mayer, K. H., Krakower, D. S., Eldahan, A. I., Gaston Hawkins, L. A., Hansen, N. B., Kershaw, T. S., Underhill, K., & Betancourt, J. R. (2016). Putting PrEP into practice: lessons learned from early-adopting US providers’ firsthand experiences providing HIV pre-exposure prophylaxis and associated care. PloS One, 11(6), e0157324.
Calabrese, S. K., Willie, T. C., Galvao, R. W., Tekeste, M., Dovidio, J. F., Safon, C. B., Blackstock, O., Taggart, T., Kaplan, C., & Caldwell, A. (2019). Current US guidelines for prescribing HIV pre-exposure prophylaxis (PrEP) disqualify many women who are at risk and motivated to use PrEP. JAIDS Journal of Acquired Immune Deficiency Syndromes, 81(4), 395–405.
Celum, C., Hosek, S., Tsholwana, M., Kassim, S., Mukaka, S., Dye, B. J., Pathak, S., Mgodi, N., Bekker, L.-G., & Donnell, D. J. (2021). PrEP uptake, persistence, adherence, and effect of retrospective drug level feedback on PrEP adherence among young women in southern Africa: Results from HPTN 082, a randomized controlled trial. PLoS Medicine, 18(6), e1003670.
Celum, C. L., Delany‐Moretlwe, S., Baeten, J. M., van der Straten, A., Hosek, S., Bukusi, E. A., McConnell, M., Barnabas, R. V, & Bekker, L. (2019). HIV pre‐exposure prophylaxis for adolescent girls and young women in Africa: from efficacy trials to delivery. Journal of the International AIDS Society, 22, e25298.
Celum, C., Morrow, R. A., Donnell, D., Hong, T., Hendrix, C. W., Thomas, K. K., Fife, K. H., Nakku-Joloba, E., Mujugira, A., & Baeten, J. M. (2014). Daily oral tenofovir and emtricitabine–tenofovir preexposure prophylaxis reduces herpes simplex virus type 2 acquisition among heterosexual HIV-1–uninfected men and women: a subgroup analysis of a randomized trial. Annals of Internal Medicine, 161(1), 11–19.
Chan, P. A., Mena, L., Patel, R., Oldenburg, C. E., Beauchamps, L., Perez‐Brumer, A. G., Parker, S., Mayer, K. H., Mimiaga, M. J., & Nunn, A. (2016). Retention in care outcomes for HIV pre‐exposure prophylaxis implementation programmes among men who have sex with men in three US cities. Journal of the International AIDS Society, 19(1), 20903.
Coelho, L. E., Torres, T. S., Veloso, V. G., Landovitz, R. J., & Grinsztejn, B. (2019). Pre-exposure prophylaxis 2.0: new drugs and technologies in the pipeline. The Lancet HIV, 6(11), e788–e799.
Collier, K. L., Colarossi, L. G., & Sanders, K. (2017). Raising awareness of pre-exposure prophylaxis (PrEP) among women in New York City: community and provider perspectives. Journal of Health Communication, 22(3), 183–189.
Desai, M., Field, N., Grant, R., & McCormack, S. (2017). Recent advances in pre-exposure prophylaxis for HIV. Bmj, 359.
Deutsch, M. B., Glidden, D. V, Sevelius, J., Keatley, J., McMahan, V., Guanira, J., Kallas, E. G., Chariyalertsak, S., & Grant, R. M. (2015). HIV pre-exposure prophylaxis in transgender women: a subgroup analysis of the iPrEx trial. The Lancet HIV, 2(12), e512–e519.
Eakle, R., Gomez, G. B., Naicker, N., Bothma, R., Mbogua, J., Cabrera Escobar, M. A., Saayman, E., Moorhouse, M., Venter, W. D. F., & Rees, H. (2017). HIV pre-exposure prophylaxis and early antiretroviral treatment among female sex workers in South Africa: results from a prospective observational demonstration project. PLoS Medicine, 14(11), e1002444.
Eakle, R., Venter, F., & Rees, H. (2018). Pre-exposure prophylaxis (PrEP) in an era of stalled HIV prevention: Can it change the game? Retrovirology, 15, 1–10.
Eaton, L. A., Matthews, D. D., Driffin, D. D., Bukowski, L., Wilson, P. A., Stall, R. D., & Team, P. S. (2017). A multi-US city assessment of awareness and uptake of pre-exposure prophylaxis (PrEP) for HIV prevention among black men and transgender women who have sex with men. Prevention Science, 18, 505–516.
Flash, C. A., Stone, V. E., Mitty, J. A., Mimiaga, M. J., Hall, K. T., Krakower, D., & Mayer, K. H. (2014). Perspectives on HIV prevention among urban Black women: A potential role for HIV pre-exposure prophylaxis. AIDS Patient Care and STDs, 28(12), 635–642.
Fonner, V. A., Dalglish, S. L., Kennedy, C. E., Baggaley, R., O’reilly, K. R., Koechlin, F. M., Rodolph, M., Hodges-Mameletzis, I., & Grant, R. M. (2016). Effectiveness and safety of oral HIV preexposure prophylaxis for all populations. Aids, 30(12), 1973–1983.
Haberer, J. E., Bangsberg, D. R., Baeten, J. M., Curran, K., Koechlin, F., Amico, K. R., Anderson, P., Mugo, N., Venter, F., & Goicochea, P. (2015). Defining success with HIV pre-exposure prophylaxis: a prevention-effective adherence paradigm. Aids, 29(11), 1277–1285.
Heffron, R., Ngure, K., Odoyo, J., Bulya, N., Tindimwebwa, E., Hong, T., Kidoguchi, L., Donnell, D., Mugo, N. R., & Bukusi, E. A. (2018). Pre-exposure prophylaxis for HIV-negative persons with partners living with HIV: uptake, use, and effectiveness in an open-label demonstration project in East Africa. Gates Open Research, 1, 3.
Hoagland, B., Moreira, R. I., De Boni, R. B., Kallas, E. G., Madruga, J. V., Vasconcelos, R., Goulart, S., Torres, T. S., Marins, L. M. S., & Anderson, P. L. (2017). High pre‐exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project. Journal of the International AIDS Society, 20(1), 21472.
Jiang, J., Yang, X., Ye, L., Zhou, B., Ning, C., Huang, J., Liang, B., Zhong, X., Huang, A., & Tao, R. (2014). Pre-exposure prophylaxis for the prevention of HIV infection in high risk populations: a meta-analysis of randomized controlled trials. PLoS One, 9(2), e87674.
Kinuthia, J., Pintye, J., Abuna, F., Mugwanya, K. K., Lagat, H., Onyango, D., Begnel, E., Dettinger, J., Baeten, J. M., & John-Stewart, G. (2020). Pre-exposure prophylaxis uptake and early continuation among pregnant and post-partum women within maternal and child health clinics in Kenya: results from an implementation programme. The Lancet HIV, 7(1), e38–e48.
Koechlin, F. M., Fonner, V. A., Dalglish, S. L., O’Reilly, K. R., Baggaley, R., Grant, R. M., Rodolph, M., Hodges-Mameletzis, I., & Kennedy, C. E. (2017). Values and preferences on the use of oral pre-exposure prophylaxis (PrEP) for HIV prevention among multiple populations: a systematic review of the literature. AIDS and Behavior, 21, 1325–1335.
Krakower, D. S., & Mayer, K. H. (2015). Pre-exposure prophylaxis to prevent HIV infection: current status, future opportunities and challenges. Drugs, 75, 243–251.
Lehman, D. A., Baeten, J. M., McCoy, C. O., Weis, J. F., Peterson, D., Mbara, G., Donnell, D., Thomas, K. K., Hendrix, C. W., & Marzinke, M. A. (2015). Risk of drug resistance among persons acquiring HIV within a randomized clinical trial of single-or dual-agent preexposure prophylaxis. The Journal of Infectious Diseases, 211(8), 1211–1218.
Liu, A. Y., Cohen, S. E., Vittinghoff, E., Anderson, P. L., Doblecki-Lewis, S., Bacon, O., Chege, W., Postle, B. S., Matheson, T., & Amico, K. R. (2016). Preexposure prophylaxis for HIV infection integrated with municipal-and community-based sexual health services. JAMA Internal Medicine, 176(1), 75–84.
Marcus, J. L., Hurley, L. B., Hare, C. B., Nguyen, D. P., Phengrasamy, T., Silverberg, M. J., Stoltey, J. E., & Volk, J. E. (2016). Preexposure prophylaxis for HIV prevention in a large integrated health care system: adherence, renal safety, and discontinuation. JAIDS Journal of Acquired Immune Deficiency Syndromes, 73(5), 540–546.
Marins, L. M. S., Torres, T. S., Leite, I. da C., Moreira, R. I., Luz, P. M., Hoagland, B., Kallas, E. G., Madruga, J. V., Liu, A. Y., & Anderson, P. L. (2019). Performance of HIV pre-exposure prophylaxis indirect adherence measures among men who have sex with men and transgender women: Results from the PrEP Brasil Study. PLoS One, 14(8), e0221281.
Marrazzo, J. M., Ramjee, G., Richardson, B. A., Gomez, K., Mgodi, N., Nair, G., Palanee, T., Nakabiito, C., Van Der Straten, A., & Noguchi, L. (2015). Tenofovir-based preexposure prophylaxis for HIV infection among African women. New England Journal of Medicine, 372(6), 509–518.
McCormack, S., Dunn, D. T., Desai, M., Dolling, D. I., Gafos, M., Gilson, R., Sullivan, A. K., Clarke, A., Reeves, I., & Schembri, G. (2016). Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. The Lancet, 387(10013), 53–60.
Montgomery, M. C., Oldenburg, C. E., Nunn, A. S., Mena, L., Anderson, P., Liegler, T., Mayer, K. H., Patel, R., Almonte, A., & Chan, P. A. (2016). Adherence to pre-exposure prophylaxis for HIV prevention in a clinical setting. PLoS One, 11(6), e0157742.
Mugo, N. R., Hong, T., Celum, C., Donnell, D., Bukusi, E. A., John-Stewart, G., Wangisi, J., Were, E., Heffron, R., & Matthews, L. T. (2014). Pregnancy incidence and outcomes among women receiving preexposure prophylaxis for HIV prevention: a randomized clinical trial. Jama, 312(4), 362–371.
Mugwanya, K. K., Hendrix, C. W., Mugo, N. R., Marzinke, M., Katabira, E. T., Ngure, K., Semiyaga, N. B., John-Stewart, G., Muwonge, T. R., & Muthuri, G. (2016). Pre-exposure prophylaxis use by breastfeeding HIV-uninfected women: a prospective short-term study of antiretroviral excretion in breast milk and infant absorption. PLoS Medicine, 13(9), e1002132.
Ngure, K., Heffron, R., Mugo, N., Thomson, K. A., Irungu, E., Njuguna, N., Mwaniki, L., Celum, C., & Baeten, J. M. (2017). Feasibility and acceptability of HIV self‐testing among pre‐exposure prophylaxis users in Kenya. Journal of the International AIDS Society, 20(1), 21234.
Roberts, S. T., Haberer, J., Celum, C., Mugo, N., Ware, N. C., Cohen, C. R., Tappero, J. W., Kiarie, J., Ronald, A., & Mujugira, A. (2016). Intimate partner violence and adherence to HIV pre-exposure prophylaxis (PrEP) in African women in HIV serodiscordant relationships: a prospective cohort study. JAIDS Journal of Acquired Immune Deficiency Syndromes, 73(3), 313–322.
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Bekker, L.-G., Roux, S., Sebastien, E., Yola, N., Amico, K. R., Hughes, J. P., Marzinke, M. A., Hendrix, C. W., Anderson, P. L., & Elharrar, V. (2018). Daily and non-daily pre-exposure prophylaxis in African women (HPTN 067/ADAPT Cape Town Trial): a randomised, open-label, phase 2 trial. The Lancet HIV, 5(2), e68–e78.
Beymer, M. R., DeVost, M. A., Weiss, R. E., Dierst-Davies, R., Shover, C. L., Landovitz, R. J., Beniasians, C., Talan, A. J., Flynn, R. P., & Krysiak, R. (2018). Does HIV pre-exposure prophylaxis use lead to a higher incidence of sexually transmitted infections? A case-crossover study of men who have sex with men in Los Angeles, California. Sexually Transmitted Infections, 94(6), 457–462.
Cáceres, C. F., Koechlin, F., Goicochea, P., Sow, P., O’Reilly, K. R., Mayer, K. H., & Godfrey‐Faussett, P. (2015). The promises and challenges of pre‐exposure prophylaxis as part of the emerging paradigm of combination HIV prevention. Journal of the International AIDS Society, 18, 19949.
Calabrese, S. K., Magnus, M., Mayer, K. H., Krakower, D. S., Eldahan, A. I., Gaston Hawkins, L. A., Hansen, N. B., Kershaw, T. S., Underhill, K., & Betancourt, J. R. (2016). Putting PrEP into practice: lessons learned from early-adopting US providers’ firsthand experiences providing HIV pre-exposure prophylaxis and associated care. PloS One, 11(6), e0157324.
Calabrese, S. K., Willie, T. C., Galvao, R. W., Tekeste, M., Dovidio, J. F., Safon, C. B., Blackstock, O., Taggart, T., Kaplan, C., & Caldwell, A. (2019). Current US guidelines for prescribing HIV pre-exposure prophylaxis (PrEP) disqualify many women who are at risk and motivated to use PrEP. JAIDS Journal of Acquired Immune Deficiency Syndromes, 81(4), 395–405.
Celum, C., Hosek, S., Tsholwana, M., Kassim, S., Mukaka, S., Dye, B. J., Pathak, S., Mgodi, N., Bekker, L.-G., & Donnell, D. J. (2021). PrEP uptake, persistence, adherence, and effect of retrospective drug level feedback on PrEP adherence among young women in southern Africa: Results from HPTN 082, a randomized controlled trial. PLoS Medicine, 18(6), e1003670.
Celum, C. L., Delany‐Moretlwe, S., Baeten, J. M., van der Straten, A., Hosek, S., Bukusi, E. A., McConnell, M., Barnabas, R. V, & Bekker, L. (2019). HIV pre‐exposure prophylaxis for adolescent girls and young women in Africa: from efficacy trials to delivery. Journal of the International AIDS Society, 22, e25298.
Celum, C., Morrow, R. A., Donnell, D., Hong, T., Hendrix, C. W., Thomas, K. K., Fife, K. H., Nakku-Joloba, E., Mujugira, A., & Baeten, J. M. (2014). Daily oral tenofovir and emtricitabine–tenofovir preexposure prophylaxis reduces herpes simplex virus type 2 acquisition among heterosexual HIV-1–uninfected men and women: a subgroup analysis of a randomized trial. Annals of Internal Medicine, 161(1), 11–19.
Chan, P. A., Mena, L., Patel, R., Oldenburg, C. E., Beauchamps, L., Perez‐Brumer, A. G., Parker, S., Mayer, K. H., Mimiaga, M. J., & Nunn, A. (2016). Retention in care outcomes for HIV pre‐exposure prophylaxis implementation programmes among men who have sex with men in three US cities. Journal of the International AIDS Society, 19(1), 20903.
Coelho, L. E., Torres, T. S., Veloso, V. G., Landovitz, R. J., & Grinsztejn, B. (2019). Pre-exposure prophylaxis 2.0: new drugs and technologies in the pipeline. The Lancet HIV, 6(11), e788–e799.
Collier, K. L., Colarossi, L. G., & Sanders, K. (2017). Raising awareness of pre-exposure prophylaxis (PrEP) among women in New York City: community and provider perspectives. Journal of Health Communication, 22(3), 183–189.
Desai, M., Field, N., Grant, R., & McCormack, S. (2017). Recent advances in pre-exposure prophylaxis for HIV. Bmj, 359.
Deutsch, M. B., Glidden, D. V, Sevelius, J., Keatley, J., McMahan, V., Guanira, J., Kallas, E. G., Chariyalertsak, S., & Grant, R. M. (2015). HIV pre-exposure prophylaxis in transgender women: a subgroup analysis of the iPrEx trial. The Lancet HIV, 2(12), e512–e519.
Eakle, R., Gomez, G. B., Naicker, N., Bothma, R., Mbogua, J., Cabrera Escobar, M. A., Saayman, E., Moorhouse, M., Venter, W. D. F., & Rees, H. (2017). HIV pre-exposure prophylaxis and early antiretroviral treatment among female sex workers in South Africa: results from a prospective observational demonstration project. PLoS Medicine, 14(11), e1002444.
Eakle, R., Venter, F., & Rees, H. (2018). Pre-exposure prophylaxis (PrEP) in an era of stalled HIV prevention: Can it change the game? Retrovirology, 15, 1–10.
Eaton, L. A., Matthews, D. D., Driffin, D. D., Bukowski, L., Wilson, P. A., Stall, R. D., & Team, P. S. (2017). A multi-US city assessment of awareness and uptake of pre-exposure prophylaxis (PrEP) for HIV prevention among black men and transgender women who have sex with men. Prevention Science, 18, 505–516.
Flash, C. A., Stone, V. E., Mitty, J. A., Mimiaga, M. J., Hall, K. T., Krakower, D., & Mayer, K. H. (2014). Perspectives on HIV prevention among urban Black women: A potential role for HIV pre-exposure prophylaxis. AIDS Patient Care and STDs, 28(12), 635–642.
Fonner, V. A., Dalglish, S. L., Kennedy, C. E., Baggaley, R., O’reilly, K. R., Koechlin, F. M., Rodolph, M., Hodges-Mameletzis, I., & Grant, R. M. (2016). Effectiveness and safety of oral HIV preexposure prophylaxis for all populations. Aids, 30(12), 1973–1983.
Haberer, J. E., Bangsberg, D. R., Baeten, J. M., Curran, K., Koechlin, F., Amico, K. R., Anderson, P., Mugo, N., Venter, F., & Goicochea, P. (2015). Defining success with HIV pre-exposure prophylaxis: a prevention-effective adherence paradigm. Aids, 29(11), 1277–1285.
Heffron, R., Ngure, K., Odoyo, J., Bulya, N., Tindimwebwa, E., Hong, T., Kidoguchi, L., Donnell, D., Mugo, N. R., & Bukusi, E. A. (2018). Pre-exposure prophylaxis for HIV-negative persons with partners living with HIV: uptake, use, and effectiveness in an open-label demonstration project in East Africa. Gates Open Research, 1, 3.
Hoagland, B., Moreira, R. I., De Boni, R. B., Kallas, E. G., Madruga, J. V., Vasconcelos, R., Goulart, S., Torres, T. S., Marins, L. M. S., & Anderson, P. L. (2017). High pre‐exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project. Journal of the International AIDS Society, 20(1), 21472.
Jiang, J., Yang, X., Ye, L., Zhou, B., Ning, C., Huang, J., Liang, B., Zhong, X., Huang, A., & Tao, R. (2014). Pre-exposure prophylaxis for the prevention of HIV infection in high risk populations: a meta-analysis of randomized controlled trials. PLoS One, 9(2), e87674.
Kinuthia, J., Pintye, J., Abuna, F., Mugwanya, K. K., Lagat, H., Onyango, D., Begnel, E., Dettinger, J., Baeten, J. M., & John-Stewart, G. (2020). Pre-exposure prophylaxis uptake and early continuation among pregnant and post-partum women within maternal and child health clinics in Kenya: results from an implementation programme. The Lancet HIV, 7(1), e38–e48.
Koechlin, F. M., Fonner, V. A., Dalglish, S. L., O’Reilly, K. R., Baggaley, R., Grant, R. M., Rodolph, M., Hodges-Mameletzis, I., & Kennedy, C. E. (2017). Values and preferences on the use of oral pre-exposure prophylaxis (PrEP) for HIV prevention among multiple populations: a systematic review of the literature. AIDS and Behavior, 21, 1325–1335.
Krakower, D. S., & Mayer, K. H. (2015). Pre-exposure prophylaxis to prevent HIV infection: current status, future opportunities and challenges. Drugs, 75, 243–251.
Lehman, D. A., Baeten, J. M., McCoy, C. O., Weis, J. F., Peterson, D., Mbara, G., Donnell, D., Thomas, K. K., Hendrix, C. W., & Marzinke, M. A. (2015). Risk of drug resistance among persons acquiring HIV within a randomized clinical trial of single-or dual-agent preexposure prophylaxis. The Journal of Infectious Diseases, 211(8), 1211–1218.
Liu, A. Y., Cohen, S. E., Vittinghoff, E., Anderson, P. L., Doblecki-Lewis, S., Bacon, O., Chege, W., Postle, B. S., Matheson, T., & Amico, K. R. (2016). Preexposure prophylaxis for HIV infection integrated with municipal-and community-based sexual health services. JAMA Internal Medicine, 176(1), 75–84.
Marcus, J. L., Hurley, L. B., Hare, C. B., Nguyen, D. P., Phengrasamy, T., Silverberg, M. J., Stoltey, J. E., & Volk, J. E. (2016). Preexposure prophylaxis for HIV prevention in a large integrated health care system: adherence, renal safety, and discontinuation. JAIDS Journal of Acquired Immune Deficiency Syndromes, 73(5), 540–546.
Marins, L. M. S., Torres, T. S., Leite, I. da C., Moreira, R. I., Luz, P. M., Hoagland, B., Kallas, E. G., Madruga, J. V., Liu, A. Y., & Anderson, P. L. (2019). Performance of HIV pre-exposure prophylaxis indirect adherence measures among men who have sex with men and transgender women: Results from the PrEP Brasil Study. PLoS One, 14(8), e0221281.
Marrazzo, J. M., Ramjee, G., Richardson, B. A., Gomez, K., Mgodi, N., Nair, G., Palanee, T., Nakabiito, C., Van Der Straten, A., & Noguchi, L. (2015). Tenofovir-based preexposure prophylaxis for HIV infection among African women. New England Journal of Medicine, 372(6), 509–518.
McCormack, S., Dunn, D. T., Desai, M., Dolling, D. I., Gafos, M., Gilson, R., Sullivan, A. K., Clarke, A., Reeves, I., & Schembri, G. (2016). Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. The Lancet, 387(10013), 53–60.
Montgomery, M. C., Oldenburg, C. E., Nunn, A. S., Mena, L., Anderson, P., Liegler, T., Mayer, K. H., Patel, R., Almonte, A., & Chan, P. A. (2016). Adherence to pre-exposure prophylaxis for HIV prevention in a clinical setting. PLoS One, 11(6), e0157742.
Mugo, N. R., Hong, T., Celum, C., Donnell, D., Bukusi, E. A., John-Stewart, G., Wangisi, J., Were, E., Heffron, R., & Matthews, L. T. (2014). Pregnancy incidence and outcomes among women receiving preexposure prophylaxis for HIV prevention: a randomized clinical trial. Jama, 312(4), 362–371.
Mugwanya, K. K., Hendrix, C. W., Mugo, N. R., Marzinke, M., Katabira, E. T., Ngure, K., Semiyaga, N. B., John-Stewart, G., Muwonge, T. R., & Muthuri, G. (2016). Pre-exposure prophylaxis use by breastfeeding HIV-uninfected women: a prospective short-term study of antiretroviral excretion in breast milk and infant absorption. PLoS Medicine, 13(9), e1002132.
Ngure, K., Heffron, R., Mugo, N., Thomson, K. A., Irungu, E., Njuguna, N., Mwaniki, L., Celum, C., & Baeten, J. M. (2017). Feasibility and acceptability of HIV self‐testing among pre‐exposure prophylaxis users in Kenya. Journal of the International AIDS Society, 20(1), 21234.
Roberts, S. T., Haberer, J., Celum, C., Mugo, N., Ware, N. C., Cohen, C. R., Tappero, J. W., Kiarie, J., Ronald, A., & Mujugira, A. (2016). Intimate partner violence and adherence to HIV pre-exposure prophylaxis (PrEP) in African women in HIV serodiscordant relationships: a prospective cohort study. JAIDS Journal of Acquired Immune Deficiency Syndromes, 73(3), 313–322.
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