Objective: We developed Healthy Families-PrEP to support perinatal women to use HIV prevention strategies. Design: Single arm study to evaluate PrEP use among pregnant women exposed to the intervention. Methods: We offered safer conception counselling including TDF/FTC as PrEP with adherence support (Healthy Families-PrEP) for women planning for pregnancy in South Africa with a partner with HIV or unknown serostatus. Women completed pregnancy and HIV testing quarterly and were followed for one year or until pregnancy end. For those initiating PrEP, electronic pillcap data and plasma were collected. We described PrEP adherence by proportion of days with pillcap openings and proportion of women with detected (≥10ng/mL) plasma tenofovir. Results: From November 2017 to January 2020, 326 women with median age 24 (IQR: 22–27) years enrolled. Partner HIV-serostatus was unknown by 316 (97%). Over 3,204 person-months of follow-up, 56 women became pregnant. Twenty-six women used PrEP during pregnancy and opened pillcaps on a mean of 53.1% (95% CI 46.9–59.3%) of days. Plasma tenofovir was detected among 25.0%, 15.4%, and 12.5% of women providing samples during months 0–3, 4–6, and 7–9. No HIV seroconversions were observed. Conclusions: We observed low pregnancy incidence. Counselling may have encouraged delayed pregnancy plans; some women may have exaggerated pregnancy plans to enroll. About half of pregnant women used PrEP and took over half of doses by pillcap. Fewer than 25% had tenofovir detected, likely reflecting pregnancy-related pharmacokinetics and adherence challenges. High interest in pregnancy PrEP use highlights the need to optimize adherence support and prevention choice.

Lynn T. Matthews

Katia J. Bruxvoort

Manjeetha Jaggernath

Yolandie Kriel

Patricia M. Smith

Jessica E. Haberer

John Bassler

Kara Bennett

Christina Psaros

David R. Bangsberg

Kathleen Wirth Hurwitz

Jennifer A. Smit

AIDS

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AIDS is the most influential journal among all journals related to AIDS, widely read by top clinicians and researchers. The journal publishes 18 issues annually, aiming to present significant advancements in an authoritative manner. The editorial team consists of internationally recognized experts who understand the needs of researchers and strive to make AIDS the most distinguished and innovative journal in the field. All submitted articles will undergo an initial review by the editors, and some may be returned to authors without further consideration. Articles that are considered for publication will undergo further evaluation by the editors and peer review, conducted by invited reviewers.

《AIDS》是所有与艾滋病相关的期刊中影响力最高的期刊，受到顶级临床医生和研究人员的广泛阅读。该期刊每年出版18期，致力于以权威的方式展示重大进展。编辑团队由国际知名专家组成，他们了解研究者的需求，努力使《AIDS》成为该领域最杰出和最具创新性的期刊。所有提交的文章将经过编辑的初步审查，部分文章可能会在没有进一步考虑的情况下退回给作者。那些被考虑出版的文章将接受编辑的进一步评估和同行评审，评审工作将由邀请的审稿人进行。

Category	Quartile
医学	2
医学, 免疫学	2
医学, 传染病学	2
医学, 病毒学	2

Use of tenofovir-based PrEP among pregnant women in South Africa

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