Evidence map›Paper›PMID 41240274›Full record

ArticleAIDS and behavior2026

Adherence to Oral HIV Pre-exposure Prophylaxis During Pregnancy and the Post-partum Period: Lessons Learned in an Open-Labelled Clinical Trial.

Nondumiso Khoza, Alicia C Desmond, Dhayendre Moodley

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In one paragraph

Article in AIDS and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03227731 (Immediate or Deferred Pre-exposure Prophylaxis for HIV Prevention), which is not on this map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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.

NCT03227731 phase2 / phase3completednot on this map

Immediate or Deferred Pre-exposure Prophylaxis for HIV Prevention: Safe Options for Pregnant and Lactating Women An Open-Label Randomised Control Study

TypeinterventionalSponsorUniversity of KwaZuluRan2017 to 2021Enrolled540ConditionsHIV-1-infectionArmsTruvada
3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

3 authors.

Nondumiso KhozaDepartment Obstetrics and Gynaecology, School of Clinical Medicine, University of KwaZulu Natal, 719 Umbilo Road, Durban, 4013, South Africa.
Alicia C DesmondCentre for the Program of AIDS Research in South Africa (CAPRISA), Durban, South Africa.
Dhayendre MoodleyDepartment Obstetrics and Gynaecology, School of Clinical Medicine, University of KwaZulu Natal, 719 Umbilo Road, Durban, 4013, South Africa. moodleyd1@ukzn.ac.za.ORCID http://orcid.org/0000-0003-1849-9631

Funding

Gilead Sciences Gilead SciencesSouth African Medical Research Council South African Medical Research Council
6 · The paper itself

Abstract

Self-reports and returned pill count as measures of adherence to the daily oral HIV preexposure prophylaxis (PrEP) regimen in clinical trials have led to misleading outcomes. There is limited adherence data for pregnant and breastfeeding women who initiated daily oral PrEP in clinical trials. In an open-label PrEP clinical trial, adherence to daily oral tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) was measured using returned pill counts during pregnancy and post-delivery, up to 54 weeks. Intracellular tenofovir diphosphate (TFV-DP) was measured in stored dried blood spot (DBS) twice during pregnancy and at 6, 26, and 54 weeks post-delivery. True adherence was estimated based on TFV-DP levels corresponding to the number of doses taken per week. Of 271 women, 244 (90.0%), 116 (42.8%), and 84 (31.0%) received PrEP during pregnancy, or until 26 or 54 weeks post-delivery, respectively. Based on pill counts, 80-95% of women took > 80% of the dispensed PrEP pills during pregnancy and postpartum. TFV-DP was undetectable in 13.8-32.9% of women during pregnancy, and 32.9-40.5% of women postpartum. Furthermore, only 21.6% and < 10% of women had TFV-DP levels equivalent to 7 doses/week during pregnancy and postpartum, respectively. Real-time pill count data overestimated adherence to a daily oral PrEP regimen among pregnant and postpartum women. Based on TFV-DP levels, only 20% of pregnant women and 10% of postpartum women had levels suggestive of adherence greater than 80%. Lack of transparency in adherence disclosure underscores the need for real-time, objective measures of adherence to inform targeted adherence counseling.Clinical Trial Number CAP016 is on ClinicalTrials.gov ( https://clinicaltrials.gov/ct2/show/NCT03227731 ).

Indexed as

Anti-HIV AgentsHIV InfectionsMedication AdherencePre-Exposure ProphylaxisPregnancy Complications, InfectiousAdenineAdministration, OralAdultEmtricitabineFemaleHumansInfectious Disease Transmission, VerticalOrganophosphatesPostpartum PeriodPregnancyTenofovirAdenineAnti-HIV AgentsEmtricitabineOrganophosphatesTenofovirtenofovir diphosphateAdherencePostpartumPre-exposure prophylaxisPregnancyTenofovir diphosphateTenofovir disoproxil fumarate

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Registered trials

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.