An Update on HIV Pre-Exposure Prophylaxis (PrEP) Among Women

Globally, cis and trans women face increasing rates of HIV, yet the uptake of existing HIV prevention medications often fails to meet their specific needs. This review examines HIV pre-exposure prophylaxis (PrEP) use among cis and trans women, including adolescent girls and young women; newcomers and migrants; sex workers; women who use drugs; and women who have been incarcerated, acknowledging intersectionality exists between these groups. A review of peer-reviewed published literature was conducted, and findings specifically on oral PrEP were synthesized. This review highlights several key themes shaping women's engagement with PrEP, including barriers to initiation and discontinuation; public health messaging and promotion; the role of women's networks; intimate partner violence; interpersonal trust in relationships; and "seasons of risk," where temporary reductions in perceived risk may lead to discontinuation. Additional themes include preferred access points for PrEP, regional differences, and clinical implications for practice. Peer support and peer navigators emerge as important mechanisms for creating safe spaces that enhance trust and sustained PrEP use. Improving PrEP uptake and persistence among women requires a multifaceted, women-centred approach that addresses clinical, social, and structural barriers. Context-specific implementation remains critical to addressing diverse lived realities and strengthening HIV prevention outcomes globally.