Evidence map›Paper›PMID 40600478›Full record

ArticleJournal of the International AIDS Society2025

PrEP preferences and early acceptability of injectable cabotegravir among pregnant and lactating people in Cape Town, South Africa: findings from the PrEPared to Choose study.

Nafisa Wara, Carey Pike, Elzette Rousseau, Pippa Macdonald, Pakama Mapukata, Bryan Leonard, Keitumetse Lebelo, Risa Hoffman, Catherine Orrell, Linda-Gail Bekker and 1 more

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Article in Journal of the International AIDS Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

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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

11 authors.

Nafisa WaraLos Angeles David Geffen School of Medicine, University of California, Los Angeles, California, USA.ORCID https://orcid.org/0000-0003-3671-5211
Carey PikeDesmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-4247-8913
Elzette RousseauDesmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-6487-6736
Pippa MacdonaldDesmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.
Pakama MapukataDesmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.
Bryan LeonardDesmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.
Keitumetse LebeloDesmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.
Risa HoffmanDivision of Infectious Diseases, Los Angeles David Geffen School of Medicine, University of California, Los Angeles, California, USA.ORCID https://orcid.org/0000-0001-9575-4574
Catherine OrrellDesmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.
Linda-Gail BekkerDesmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-0755-4386
Dvora Joseph DaveyDivision of Infectious Diseases, Los Angeles David Geffen School of Medicine, University of California, Los Angeles, California, USA.ORCID https://orcid.org/0000-0001-6290-9293

Funding

Virology CoreP30AI028697 · NIAID · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ZACK, JEROME A. · 1991 to 2018
$39.9M
UCLA-CDU CFARP30AI152501 · NIAID · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SCOTT G KITCHEN · 2022 to 2026
$15.6M
Bill and Melinda Gates FoundationNIAID NIH HHS P30 AI028697NIAID NIH HHS P30 AI152501
6 · The paper itself

Abstract

introductionProviding pregnant and lactating people (PLP) with choice in HIV pre-exposure prophylaxis (PrEP) methods, including long-acting injectable cabotegravir (CAB-LA), may mitigate barriers to effective PrEP use. We evaluated PrEP preferences and acceptability among PLP offered CAB-LA versus oral PrEP in South Africa.

methodsThe PrEPared to Choose study in Cape Town, South Africa, enrolled young people ages 15-29 at one public clinic and one community-based mobile clinic. Using informed choice counselling, participants were offered oral PrEP or CAB-LA, with the option to switch methods at follow-up visits over 18 months. We report baseline CAB-LA and oral PrEP initiations among PLP in the study, acceptability of their initial choice within 3 months of enrolment and theoretical preferences regarding PrEP methods that may become available to PLP. We report descriptive statistics and use Chi-square and Fisher's exact to compare responses by initiated PrEP method and pregnancy status.

resultsFrom February to August 2024, we enrolled 58 PLP (n = 30 pregnant, n = 28 breastfeeding). Median age 23 years (IQR 19.5-26). Of 30 pregnant participants, 23 (77%) initiated CAB-LA and seven (23%) oral PrEP; among 28 breastfeeding participants, 25 (89%) initiated CAB-LA and three (11%) oral PrEP. Of enrolled PLP, 36 (62%, n = 13 pregnant, n = 23 breastfeeding) completed the acceptability survey. Of these, 83% (n = 12/13 pregnant, n = 20/23 breastfeeding) chose and received CAB-LA, and the remaining (n = 4) chose and received oral PrEP. PLP who received CAB-LA reported liking its ease of use (69%; n = 22/32) and long-acting protection (44%; n = 14/32). Half of CAB-LA users disliked side effects (e.g. injection site pain), although 41% of PLP (n = 13/32) described no CAB-LA dislikes. Almost all (97%; n = 31/32) PLP currently using CAB-LA were interested in continuing CAB-LA, and all PLP using oral PrEP reported interest in trying CAB-LA in the future. Eighty-six percent of surveyed PLP (n = 31/36) did not want to try the dapivirine vaginal ring.

conclusionsPLP in South Africa had a strong preference for CAB-LA over oral PrEP, and CAB-LA was found to be highly acceptable. Further research is needed to evaluate the effect of offering choice of PrEP methods, including CAB-LA, on PrEP continuation among PLP.

Indexed as

Anti-HIV AgentsHIV InfectionsPatient Acceptance of Health CarePre-Exposure ProphylaxisPregnancy Complications, InfectiousPyridonesAdministration, OralAdolescentAdultDiketopiperazinesFemaleHumansInjectionsLactationPregnancySouth AfricaAnti-HIV AgentscabotegravirDiketopiperazinesPyridonesCAB‐LAlactationpregnancy; breastfeedingPrEPSouth Africa

Identifiers

PMID40600478
PMCPMC12215810

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.