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Low HIV Preexposure Prophylaxis Coverage Among Women: Focused, Innovative Strategies Can Increase Use-United States,
Karen W Hoover1, Weiming Zhu1, Kristen L Hess1
1All authors are with the Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
American Journal of Public Health
|April 24, 2025
Summary
Pre-exposure prophylaxis (PrEP) use among women in the US has increased, but remains low. Targeted public health and clinical interventions can boost PrEP uptake and help end the HIV epidemic.
Area of Science:
- Public Health
- Epidemiology
- HIV Prevention
Background:
- Pre-exposure prophylaxis (PrEP) is a critical tool for HIV prevention.
- Increased PrEP use has been observed since its FDA approval in 2012.
- Understanding PrEP utilization trends among women is essential for public health strategies.
Purpose of the Study:
- To describe trends in PrEP use among women in the United States.
- To analyze PrEP-to-diagnosis ratios (PDR) for women nationally and in high-HIV-burden counties.
- To explore the relationship between public health activities and PrEP use in women.
Main Methods:
- Utilized national pharmacy and HIV surveillance data to calculate the annual PrEP-to-diagnosis ratio (PDR) for women from 2017 to 2023.
- Calculated PDRs in 2023 for the 20 US counties with the highest number of diagnosed HIV infections among women.
- Reviewed public health activities funded by the CDC aimed at HIV prevention.
Main Results:
- The national PDR for women increased from 1.5 in 2017 to 5.8 in 2023.
- In the top 20 counties for diagnosed HIV among women, PDRs varied widely, ranging from 2.2 to 16.9.
- Counties with higher PDRs were more likely to implement PrEP activities specifically designed for women.
Conclusions:
- While PrEP is highly effective for women's HIV prevention, uptake has been limited.
- Public health and clinical interventions tailored to women can significantly increase PrEP use.
- Enhancing women-centered PrEP strategies is crucial for advancing efforts to end the US HIV epidemic.
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