Evidence map›Paper›PMID 41656212›Full record

ArticleBMC public health2026

Oral PrEP use among pregnant or parenting young women in South Africa: evidence from a large community-based implementation study.

Jenny Chen-Charles, Dvora Joseph Davey, Elzette Rousseau, Francesca Little, Elona Toska, Ntombovuyo Mathola, Pippa Macdonald, Onesimo Vanto, Melissa Wallace, Linda-Gail Bekker

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Article in BMC public health, 2026. 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
–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

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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.

  1. Article
4 · The record

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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

10 authors.

Jenny Chen-CharlesDesmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa. jenny.chen1@alumni.lshtm.ac.uk.
Dvora Joseph DaveyDesmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
Elzette RousseauDesmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
Francesca LittleDepartment of Statistical Sciences, University of Cape Town, Cape Town, South Africa.
Elona ToskaCentre for Social Science Research, University of Cape Town, Cape Town, South Africa.
Ntombovuyo MatholaDesmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
Pippa MacdonaldDesmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
Onesimo VantoDesmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
Melissa WallaceDesmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
Linda-Gail BekkerDesmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa.

Funding

Bill and Melinda Gates Foundation INV033649
6 · The paper itself

Abstract

backgroundThe risk of HIV acquisition is heightened during pregnancy and early parenthood with the additional risk of vertical HIV transmission. While recent studies have improved our understanding of PrEP use among pregnant and breastfeeding women, further evidence is needed to inform the design of interventions that support sustained use, especially among young women who are pregnant or parenting.

methodsWe analysed data from young women aged 15-29 years who initiated PrEP in an implementation study (FastPrEP) in Cape Town, South Africa. Logistic regression was used to examine the association between pregnancy or parenting status (≥ 1 living child) and PrEP discontinuation at 1- and 4-months post-initiation, based on pharmacy refill data. The primary exposure was currently pregnant or having a child (vs. not); secondary analyses stratified by age (15-24 vs. 25-29 years) among women who were pregnant/parenting. Models were adjusted for age and hypothesised explanatory factors were included in sensitivity analysis: service delivery location, contraceptive use, HIV risk perception, and relationship status.

resultsBetween August 2022 and June 2024 n = 4,876 young women initiated PrEP; 44% were pregnant/parenting (of which 10% were pregnant), and the median age was 21.6 years (IQR:18-25). At 1-month, women who were pregnant/parenting had higher odds of PrEP discontinuation (aOR:1.30, 95% CI:1.14-1.49). At 4-months this relationship persisted (aOR:1.41, 95% CI:1.12-1.78) compared with non-pregnant/parenting women. Among those pregnant/parenting, younger women (15-24 years) had higher odds of discontinuation at 1-month (aOR:1.31, 95% CI:1.08-1.58) and 4-months (aOR:1.41, 95%CI:1.02-1.96) compared to women aged 25-29. In the fully adjusted multivariable model, receiving PrEP in mobile clinics (aOR:0.71, 95% CI:0.61-0.82) vs. government clinics was associated with lower odds of early discontinuation.

conclusionYoung women who are pregnant/parenting face elevated risk of early PrEP discontinuation. Differentiated, life-stage and youth-responsive interventions, such as counselling, partner involvement, and integration with maternal and child health, or sexual and reproductive health services, are critical to improving PrEP persistence among this priority population. This population should be prioritised in the rollout of long-acting PrEP formulations, which may better align with their needs and reduce the burden of daily adherence.

Indexed as

Anti-HIV AgentsHIV InfectionsParentingPre-Exposure ProphylaxisAdministration, OralAdolescentAdultFemaleHumansPregnancySouth AfricaYoung AdultAnti-HIV AgentsAdolescent girls and young womenHIV preventionLMICPre-exposure prophylaxis (PrEP)Pregnant and parenting women

Identifiers

PMID41656212
PMCPMC13001187

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LicenceCC BY
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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.