Ngugi Sophia, Echoka Elizabeth, Were Vincent, Kazungu Jacob, Ngure Kenneth
School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
Kenya Medical Research Institute, Nairobi, Kenya.
AIDS Behav. 2025 Jul 21. doi: 10.1007/s10461-025-04821-9.
HIV remains a major public health problem in low- and middle-income countries (LMICs). While oral pre-exposure prophylaxis (PrEP) is documented as safe and effective for HIV prevention, adherence remains a challenge. Long-acting PrEP could address adherence challenges associated with oral PrEP and significantly reduce HIV acquisition among high-risk populations. However, evidence of preferences for long-acting products remains limited, especially in LMICs. Understanding the preferences is crucial for informing the design of interventions to enhance not only adherence but also uptake. We conducted a systematic review to investigate preferences for long-acting PrEP among women of reproductive age (WRA), 15-49 years in LMICs. We searched PubMed, CINAHL and EMBASE databases for empirical literature relevant to our study, published between January 2010 and April 2024. Additional articles were manually searched for in the reference lists of included articles. We identified 20 studies reporting preferences for long-acting PrEP alone or in comparison with short-acting PrEP, such as oral daily pills, vaginal gels or suppositories. We found that WRA preferred long-acting PrEP products comprising injectables, implants and vaginal rings over short-acting options. The preferences were associated with product attributes, including longer duration of action, less frequent dosing, effectiveness and fewer side effects. The findings suggest that, in addition to oral PrEP, long-acting PrEP products can be employed as a strategy to reduce the burden of HIV among WRA in LMIC settings. Further research should be conducted to evaluate preferences in specific population groups, such as pregnant and lactating women, especially in high HIV prevalence settings.
在低收入和中等收入国家（LMICs），艾滋病毒仍然是一个主要的公共卫生问题。虽然口服暴露前预防（PrEP）被证明对预防艾滋病毒是安全有效的，但坚持用药仍然是一项挑战。长效PrEP可以解决与口服PrEP相关的坚持用药问题，并显著降低高危人群感染艾滋病毒的几率。然而，对于长效产品的偏好证据仍然有限，尤其是在低收入和中等收入国家。了解这些偏好对于设计不仅能提高坚持用药率而且能提高接受率的干预措施至关重要。我们进行了一项系统综述，以调查低收入和中等收入国家15至49岁育龄妇女（WRA）对长效PrEP的偏好。我们在PubMed、CINAHL和EMBASE数据库中搜索了2010年1月至2024年4月期间发表的与我们研究相关的实证文献。还在纳入文章的参考文献列表中手动搜索了其他文章。我们确定了20项研究，这些研究报告了对长效PrEP单独或与短效PrEP（如口服每日药丸、阴道凝胶或栓剂）相比的偏好。我们发现，育龄妇女更喜欢长效PrEP产品，包括注射剂、植入剂和阴道环，而不是短效产品。这些偏好与产品属性有关，包括作用时间更长、给药频率更低、有效性和副作用更少。研究结果表明，除了口服PrEP之外，长效PrEP产品可以作为一种策略，以减轻低收入和中等收入国家育龄妇女中的艾滋病毒负担。应开展进一步研究，以评估特定人群组（如孕妇和哺乳期妇女）的偏好，尤其是在艾滋病毒高流行环境中。
