P r EP introduction for Adolescent Girls and Young Women Girls and HIV AIDS2016 Satellite Session Durban South Africa July 21 2016 Sanyukta Mathur Population Council What is Oral PrEP New biomedical tool to prevent HIV infection ID: 766066
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PrEP introduction for Adolescent Girls and Young Women Girls and HIVAIDS2016 Satellite SessionDurban, South AfricaJuly 21, 2016 Sanyukta Mathur, Population Council
What is Oral PrEP?New biomedical tool to prevent HIV infection Daily use of oral tenofovir-based antiretroviral formulations as pre-exposure prophylaxis—or PrEP
What do we know about PrEP efficacy? PrEP has been shown to be effective for MSM, transgender women, people who inject drugs, heterosexual men and womenPrEP for young women in Africa: one RCT showed a reduction in HIV (age <30), another did not (age <25)Young women and men had poorer adherence to PrEP, and diminished effectivenessIn open label studies, women self-select, know efficacy of product, have higher adherence, and PrEP had higher effectiveness
What don’t we know? Effectiveness for young womenAcceptance (also among providers, policymakers)Where/how to provide comprehensive HIV prevention, including PrEPAdherence support strategies
PrEP for AGYW Framework for PrEP Introduction
Who are the key actors?AGYWHealth care providersMale partnersParents, guardians Policy makers
What to ask?Young Women PrEP attributes, acceptability and potential useRisk perception and compensationGendered power dynamicsStigma and social acceptabilityService delivery models and strategiesHealth Care Providers PrEP knowledge, attitudes and perceptions Stigma/provider biases Legal and ethical considerations Service delivery considerations Service access and quality of care
What we need to do? Targeted PrEP delivery: Identify girls who are at riskConduct demonstration projects—deliver in ”real world” with safeguardsInclude PrEP as part of a package of comprehensive HIV prevention methods for young womenBuild evidence to guide oral PrEP introduction and roll-out for young women