Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Jan;11(1):18-26.
doi: 10.1097/COH.0000000000000207.

Tenofovir-based oral preexposure prophylaxis prevents HIV infection among women

Kerry A Thomson  1 , Jared M Baeten, Nelly R Mugo, Linda-Gail Bekker, Connie L Celum, Renee Heffron
Affiliations
Review

Tenofovir-based oral preexposure prophylaxis prevents HIV infection among women

Kerry A Thomson et al. Curr Opin HIV AIDS. 2016 Jan.

Abstract

Purpose of review: Despite tremendous promise as a female-controlled HIV prevention strategy, implementation of preexposure prophylaxis (PrEP) among women has been limited, in part because of disparate efficacy results from randomized trials in this population. This review synthesizes existing evidence regarding PrEP efficacy for preventing HIV infection in women and considerations for delivering PrEP to women.

Recent findings: In three efficacy trials, conducted among men and women, tenofovir-based oral PrEP reduced HIV acquisition in subgroups of women by 49-79% in intent-to-treat analyses, and by >85% when accounting for PrEP adherence. Two trials did not demonstrate an HIV prevention benefit from PrEP in women, but substantial evidence indicates those results were compromised by very low adherence to the study medication. Qualitative research has identified risk perception, stigma, and aspects of clinical trial participation as influencing adherence to study medication. Pharmacokinetic studies provide supporting evidence that PrEP offers HIV protection in women who are adherent to the medication.

Summary: Tenofovir-based daily oral PrEP prevents HIV acquisition in women. Offering PrEP as an HIV prevention option for women at high risk of HIV acquisition is a public health imperative and opportunities to evaluate implementation strategies for PrEP for women are needed.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest

None.

Figures

Figure 1
Figure 1
Schematic depicting the totality of evidence for tenofovir-based oral pre-exposure prophylaxis (PrEP) to prevent HIV among women
See this image and copyright information in PMC

References

    1. Adimora AA, Ramirez C, Auerbach JD, et al. Preventing HIV infection in women. Journal of Acquired Immune Deficiency Syndromes. 2013;63:S168–S173. - PMC - PubMed
    1. Ramjee G, Daniels B. Women and HIV in Sub-Saharan Africa. AIDS Research and Therapy. 2013;10 - PMC - PubMed
    1. Baeten JM, Haberer JE, Liu AY, Sista N. Preexposure prophylaxis for HIV prevention: Where have we been and where are we going? Journal of Acquired Immune Deficiency Syndromes. 2013;63:S122–S129. - PMC - PubMed
    1. United States Public Health Service. Preexposure Prophylaxis for the Prevention of HIV Infection in the United States: 2014 Clinical Practice Guideline. 2014 These guidelines recommend daily oral PrEP as TDF/FTC for heterosexual women who are at substantial risk of HIV acquisition, including during the periconception and pregnancy periods.
    1. United States Department of Health and Human Services Panel on Treatment of Hiv-Infected Pregnant Women and Prevention of Perinatal Transmission. Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1- Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States. 2014 These guidelines state that PrEP is not contraindicated during pregnancy and is a recommended strategy for HIV uninfected women who are at high risk of HIV acquisition before and during pregnancy, including PrEP as a safer conception strategy for HIV serodiscordant couples.

MeSH terms