Preferences and acceptability for long-acting PrEP agents among pregnant and postpartum women with experience using daily oral PrEP in South Africa and Kenya.
Preferences and acceptability for long-acting PrEP agents among pregnant and postpartum women with experience using daily oral PrEP in South Africa and Kenya.
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DOI：
10.1002/jia2.26088
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发表时间：
2023-05
影响因子：
6
通讯作者：
中科院分区：
文献类型：
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Long‐acting pre‐exposure prophylaxis (PrEP) options could overcome barriers to oral PrEP persistence during pregnancy and postpartum. We evaluated long‐acting PrEP preferences among oral PrEP‐experienced pregnant and postpartum women in South Africa and Kenya, countries with high PrEP coverage with pending regulatory approvals for long‐acting injectable cabotegravir and the dapivirine vaginal ring (approved in South Africa, under review in Kenya). From September 2021 to February 2022, we surveyed pregnant and postpartum women enrolled in oral PrEP studies in South Africa and Kenya. We evaluated oral PrEP attitudes and preferences for long‐acting PrEP methods in multivariable logistic regression models adjusting for maternal age and country. We surveyed 190 women in South Africa (67% postpartum; median age 27 years [IQR = 22–32]) and 204 women in Kenya (79% postpartum; median age 29 years [IQR = 25–33]). Seventy‐five percent of participants reported oral PrEP use within the last 30 days. Overall, forty‐nine percent of participants reported negative oral PrEP attributes, including side effects (21% South Africa, 30% Kenya) and pill burden (20% South Africa, 25% Kenya). Preferred PrEP attributes included long‐acting method, effectiveness, safety while pregnant and breastfeeding, and free medication. Most participants (75%, South Africa and Kenya) preferred a potential long‐acting injectable over oral PrEP, most frequently for a longer duration of effectiveness in South Africa (87% South Africa, 42% Kenya) versus discretion in Kenya (5% South Africa, 49% Kenya). Eighty‐seven percent of participants preferred oral PrEP over a potential long‐acting vaginal ring, mostly due to concern about possible discomfort with vaginal insertion (82% South Africa, 48% Kenya). Significant predictors of long‐acting PrEP preference included past use of injectable contraceptive (aOR = 2.48, 95% CI: 1.34, 4.57), disliking at least one oral PrEP attribute (aOR = 1.72, 95% CI: 1.05, 2.80) and preferring infrequent PrEP use (aOR = 1.58, 95% CI: 0.94, 2.65). Oral PrEP‐experienced pregnant and postpartum women expressed a theoretical preference for long‐acting injectable PrEP over other modalities, demonstrating potential acceptability among a key population who must be at the forefront of injectable PrEP rollout. Reasons for PrEP preferences differed by country, emphasizing the importance of increasing context‐specific options and choice of PrEP modalities for pregnant and postpartum women.
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影响因子：
4.4
作者：
Mayo AJ;Browne EN;Montgomery ET;Torjesen K;Palanee-Phillips T;Jeenarain N;Seyama L;Woeber K;Harkoo I;Reddy K;Tembo T;Mutero P;Tauya T;Chitukuta M;Gati Mirembe B;Soto-Torres L;Brown ER;Baeten JM;van der Straten A;MTN-020/ASPIRE study team
通讯作者：
MTN-020/ASPIRE study team
影响因子：
16.1
作者：
Amico, K. Rivet;Bekker, Linda-Gail
通讯作者：
Bekker, Linda-Gail
影响因子：
4.4
作者：
Beesham I;Heffron R;Evans S;Baeten JM;Smit J;Beksinska M;Mansoor LE
通讯作者：
Mansoor LE
影响因子：
6
作者：
Joseph Davey DL;Mvududu R;Mashele N;Lesosky M;Khadka N;Bekker LG;Gorbach P;Coates TJ;Myer L
通讯作者：
Myer L
影响因子：
--
作者：
Bush, K;Kivlahan, DR;Bradley, KA
通讯作者：
Bradley, KA