Cisgender women who consistently take TDF/FTC (Truvada or generic equivalents) for pre-exposure prophylaxis (PrEP) are protected as well as gay men, but a majority don’t achieve high enough adherence. In an analysis of nearly 3,000 women in 11 PrEP demonstration projects, mostly in Africa and India, only 39% had adequate adherence. There were no new HIV diagnoses among women with consistent daily adherence (seven pills per week) and only one among those with consistently high adherence (four to six pills). But HIV incidence rates were higher among those with high but declining PrEP adherence or consistently low adherence. In another study, researchers analyzed data from two trials that compared daily TDF/FTC (tenofovir disoproxil fumarate/emtricitabine) versus long-acting Apretude (cabotegravir) injections. They calculated that men achieved 99% efficacy at a lower adherence threshold of two or more pills per week, while women required daily dosing, suggesting higher adherence is needed for women.
Prevention: PrEP for Women
There were no new HIV diagnoses among women with consistent daily adherence and only one among those with consistently high adherence.
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