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HIV Preexposure Prophylaxis With Emtricitabine
and Tenofovir Disoproxil Fumarate Among Cisgender Women
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March 1 JAMA. 2024
Download the PDF here
Download the PDF here
Jeanne Marrazzo, MD; Li Tao, PhD; Marissa Becker, MD; Ashley A. Leech, PhD, MS; Allan W. Taylor, MD, MPH;
Faith Ussery, MPH; Michael Kiragu, MBBS; Sushena Reza-Paul, MBBS, MPH, PhD; Janet Myers, PhD, MPH;
Linda-Gail Bekker, PhD; Juan Yang, PhD; Christoph Carter, MD, PhD; Melanie de Boer, PhD; Moupali Das, MD;
Jared M. Baeten, MD; Connie Celum, MD, MPH
This pooled analysis of more than 6000 cisgender women using F/TDF for PrEP showed higher HIV incidence among younger, married, and nulliparous women, which is consistent with previous reports.34 Among the nearly 3000 individuals with adherence data, the effectiveness of F/TDF in preventing HIV infection was very high in women who demonstrated consistently high (4-6 doses/week) or consistently daily (7 doses/week) adherence. This interpretation is comparable to the established relationship between effectiveness and adherence observed in cisgender MSM. Even with the relatively low number of incident HIV diagnoses, a clear relationship was observed between evidence (both objective and subjective) of higher adherence with lower risk of HIV infection.
None of the 498 women with consistently daily adherence acquired HIV. Only 1 of the 658 women with consistently high adherence acquired HIV (incidence rate, 0.13/100 person-years [95% CI, 0.02-0.92]).
A total of 12 incident HIV infections were observed among the 2955 participants with adherence data, compared with 20 diagnoses among 3341 participants without adherence data. None of the 498 participants with consistently daily adherence by group-based trajectory acquired HIV (Figure 4); because there were no cases of infection, an IRR could not be calculated for this group. Only 1 of the 658 participants with consistently high adherence (4-6 doses/week) acquired HIV
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