In a region with 15-20% HIV prevalence, an estimated 20% of HIV-uninfected women could have
HIV exposures in pregnancy. In a theoretical scenario of perfect PrEP coverage, all women at
risk receive PrEP while no women not at HIV risk receive PrEP (Figure 4). With mandatory PrEP
given to all women (similar to the approaches used for malaria prophylaxis), all women at
risk would be covered but many women not at risk receive unnecessary PrEP. Our premise is
that a targeted PrEP model may be closer to perfect coverage than a universal
offer/self-select model. Implementing targeted PrEP through strategies that include
facilitation of partner testing with self-tests could add HIV prevention benefit by
increasing partner HIV diagnosis and treatment similar to the initiation of PrEP among
pregnant women. By implementing these strategies and measuring uptake, process, and HIV
incidence, we can inform the best health systems model for PrEP delivery in pregnancy.
Phase:
Phase 4
Details
Lead Sponsor:
University of Washington
Collaborators:
Kenyatta National Hospital National Institute of Allergy and Infectious Diseases (NIAID)