Evidence map›Paper›PMID 34178226›Full record

SynthesisThe Pan African medical journal2021

The effectiveness of tenofovir-based pre-exposure prophylaxis for prevention of HIV acquisition among sub-Saharan African women at high risk: a systematic review.

Grant Murewanhema, Moffat Malisheni, Noah Fongwen Takah

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in The Pan African medical journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 53% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Review
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

3 authors at 2 institutions in 2 countries.

Grant MurewanhemaDepartment of Obstetrics and Gynaecology, College of Health Sciences, University of Zimbabwe, Avondale, Harare, Zimbabwe.
Moffat MalisheniMinistry of Health, Lusaka, Zambia.
Noah Fongwen TakahLimbe Regional Hospital, Ministry of Public Health, Yaoundé, Cameroon.
Ministry of Health · ZMUniversity of Zimbabwe · ZW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionwomen in sub-Saharan Africa (SSA) are disproportionately affected by the HIV epidemic. In 2019, they constituted 59% of new infections; thus, they remain a key population for control. Public health interventions to prevent acquisition of HIV in this high-risk population are urgently needed. Tenofovir-based pre-exposure prophylaxis (TFV-PrEP) has been shown to reduce HIV infections in other key populations. However, comprehensive evidence regarding TFV-PrEP effectiveness in women living in SSA has not been determined. Therefore, we undertook a systematic review to determine the effectiveness of tenofovir-1% (TFV-1%) vaginal gel, oral tenofovir (TFV) and tenofovir-emtricitabine (TDF-FTC) pre-exposure prophylaxis for primary acquisition of HIV in at-risk women living in SSA.

methodsOVID Medline, Embase, CENTRAL, Web of Science and Clinical Trials.gov were searched for eligible studies from 1

resultsfrom 2002 non-duplicate articles, four RCTs evaluating the effectiveness of one or more of the interventions against placebos were included. TFV-1% vaginal gel, oral TDF or TDF-FTC were not effective in preventing the acquisition of HIV infection in women living in SSA. However, poor adherence by study participants could have confounded the true effectiveness of TFV-PrEP in this high risk population. Meta-analysis was not conducted given the limited number of eligible studies identified from the search.

conclusionthe current evidence does not support the effectiveness of TFV-PrEP for HIV in SSA women. More studies aimed at addressing factors driving low adherence to HIV interventions in this high risk population are urgently needed in order to improve the design of future RCTs leading to the determination of more reliable estimates of TFV-1% vaginal gel or oral TDF or TDF-FTC effectiveness. Protocol registration: this systematic review was not registered in PROSPERO.

Indexed as

Africa South of the SaharaAnti-HIV AgentsDrug MonitoringEmtricitabine, Tenofovir Disoproxil Fumarate Drug CombinationFemaleHIV InfectionsHumansPre-Exposure ProphylaxisRandomized Controlled Trials as TopicTenofovirAnti-HIV AgentsEmtricitabine, Tenofovir Disoproxil Fumarate Drug CombinationTenofovireffectivenessHuman immunodeficiency viruspre-exposure prophylaxissub-Saharan Africatenofovirtruvadavaginal gel

Identifiers

PMID34178226
PMCPMC8197052
OpenAlexW3141335327

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.