Evidence map›Paper›PMID 30447703›Full record

ReviewSexual health2018

Global and national guidance for the use of pre-exposure prophylaxis during peri-conception, pregnancy and breastfeeding.

Natasha Davies, Renee Heffron

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Sexual health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 3 pooled it
2.3field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 33 citations in OpenAlex.

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  11. "Frontiers in reproductive health · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 3 countries.

Natasha DaviesWits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, 22 Esselen Street, Johannesburg, South Africa.
Renee HeffronDepartments of Global Health and Epidemiology, University of Washington, 325 Ninth Avenue Box 359927, Seattle, WA 98104, USA.
Textron Systems (United Kingdom) · GBUniversity of the Witwatersrand · ZA

Funding

Antiretroviral periconception HIV prevention for HIV discordant couplesR00HD076679 · NICHD · UNIVERSITY OF WASHINGTON · PI HEFFRON, RENEE A. · 2015 to 2017
$742k
Antiretroviral periconception HIV prevention for HIV discordant couplesK99HD076679 · NICHD · UNIVERSITY OF WASHINGTON · PI HEFFRON, RENEE A. · 2013 to 2014
$208k
NICHD NIH HHS K99 HD076679NICHD NIH HHS R00 HD076679
6 · The paper itself

Abstract

Pre-exposure prophylaxis (PrEP) is a well-established biomedical HIV prevention strategy and recommended to reduce HIV risk during peri-conception, pregnancy and breastfeeding. Efforts are needed to translate global recommendations into national guidelines and implementation strategies. This article presents the current status of policy guidance for the use of PrEP during peri-conception, pregnancy and breastfeeding, with a particular focus on high prevalence countries, including those in sub-Saharan Africa. PrEP clinical guidelines released by ministries of health or other national-level health bodies, with a particular focus on recommendations for PrEP use during peri-conception, pregnancy and breastfeeding, were reviewed and summarised. Among countries with PrEP guidelines and/or policy, pregnancy is recognised as a period with increased HIV vulnerability, and some recommend PrEP use specifically during pregnancy. Only one country notes that PrEP is contraindicated during pregnancy, recognising a gap in complete safety data from women using PrEP throughout pregnancy. PrEP is not contraindicated as a peri-conception HIV prevention strategy in any country, but only three countries have specific guidance for peri-conception HIV prevention. Multiple barriers to the implementation of PrEP during pregnancy and breastfeeding are discussed, including barriers at the policy, health systems, social and personal levels. Although pregnancy is a period of heightened risk and fertility rates are high in many settings with high HIV burden, few PrEP policies have included guidance for PrEP use specific to peri-conception, pregnancy and breastfeeding periods. This gap can be overcome by the development or adoption of national clinical guidelines and implementation strategies from exemplary countries.

Indexed as

Global HealthAdministration, OralAdolescentAdultAnti-HIV AgentsBreast FeedingDrug Therapy, CombinationFemaleHIV InfectionsHumansMiddle AgedPractice Guidelines as TopicPreconception CarePre-Exposure ProphylaxisPregnancyPregnancy Complications, InfectiousAnti-HIV AgentsTenofovir

Identifiers

PMID30447703
PMCPMC6790372
OpenAlexW2901432425

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.