Abstract
Pre-exposure prophylaxis (PrEP) has proven to be highly effective in preventing HIV in uninfected persons when properly adhered to. East and Southern African countries that suffer from high HIV prevalence and incidence are increasingly adopting PrEP as an HIV prevention strategy for their high-risk populations, including for young women. Structural factors such as poverty, lack of education, and gender-based violence may compromise their PrEP uptake and adherence, however. Choice-disabled young women are most at risk of HIV infection and least able to apply HIV prevention choices. For successful rollout of this biomedical solution, we need structural interventions that address these underlying drivers of the HIV epidemic.
Key words: HIV, prevention, pre-exposure prophylaxis, women, Africa
Résumé
Lorsqu’elle est bien suivie, la prophylaxie pré-exposition (PPrE) s’avère hautement efficace pour prévenir le VIH chez les personnes non infectées. Les pays d’Afrique de l’Est et d’Afrique australe aux prises avec des taux élevés de prévalence et d’incidence du VIH adoptent de plus en plus la PPrE comme stratégie de prévention du VIH dans leurs populations à risque élevé, en particulier les jeunes femmes. Les facteurs comme la pauvreté, le manque d’instruction et la violence sexiste peuvent toutefois compromettre l’utilisation et l’observance de la PPrE dans ces populations. Les jeunes femmes défavorisées sur le plan des choix sont les plus vulnérables aux infections à VIH et les moins capables de mettre en pratique les choix de prévention du VIH. Pour un déploiement réussi de cette solution biomédicale, nous avons besoin d’interventions structurelles qui tiennent compte des vecteurs sous-jacents de l’épidémie de VIH.
Mots clés: VIH, prévention, prophylaxie pré-exposition, femmes, Afrique
Footnotes
Acknowledgements: We thank Neil Andersson for his review of this manuscript.
Funding: RW is funded by the Fonds de recherche du Québec - Santé (FRQS) and the Lloyd Carr-Harris Foundation; DL is funded by the FRQS.
Conflict of Interest: None to declare.
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