Oral HIV pre-exposure prophylaxis use among pregnant and postpartum women: results from real-world implementation in Lesotho

Lieketseng J Masenyetse; Lauren Greenberg; Felleng Samonyane; Bokang Sekepe; Majoalane Mokone; Mafusi J Mokone; Vincent J Tukei; Laura K Beres

doi:10.3389/frph.2023.1221752

Oral HIV pre-exposure prophylaxis use among pregnant and postpartum women: results from real-world implementation in Lesotho

Front Reprod Health. 2023 Jul 31:5:1221752. doi: 10.3389/frph.2023.1221752. eCollection 2023.

Authors

Lieketseng J Masenyetse¹, Lauren Greenberg², Felleng Samonyane¹, Bokang Sekepe¹, Majoalane Mokone¹, Mafusi J Mokone¹, Vincent J Tukei^{1

3}, Laura K Beres⁴

Affiliations

¹ Elizabeth Glaser Pediatric AIDS Foundation, Maseru, Lesotho.
² Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, United States.
³ Elizabeth Glaser Pediatric AIDS Foundation, Mbabane, Eswatini.
⁴ Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.

Abstract

Introduction: Lesotho has reached epidemic control, PrEP is an important component in maintaining that and in reaching the goal of eliminating mother-to-child transmission.

Methods: We conducted a retrospective review of existing, routine PrEP health records in 26 health facilities in Lesotho. PrEP visit data were collected for pregnant and postpartum women screened for PrEP and/or enrolled in PrEP programs from 1 January 2019 through 30 June 2021 with follow-up data collected up to the date of data abstraction per site between October 2021 and May 2022. Poisson regression with robust variance was used to evaluate the association between patient characteristics and continuation of PrEP.

Results: Indications for starting PrEP were significantly associated with continuation in PrEP use. Women starting PrEP due to having a partner known to be living with HIV were the most likely to return for follow-up. In all age groups, the most common reason for starting PrEP was being in a serodiscordant relationship, though the proportion varies by age.

Conclusion: As Lesotho is now in the process of optimizing PrEP use among pregnant and postpartum women, it is critical to revise data sources to capture information that will link PrEP records and ANC/PNC records and document pregnancy/postpartum status in order to better understand PrEP use and gaps in this population.

Keywords: HIV; PrEP; breastfeeding; medical records; postpartum; pregnant women; prevention; sub-Saharan Africa.

Grants and funding

The research was supported by the United States Agency for International Development (USAID) and the generous support of the American people through USAID Cooperative Agreement AID-674-A-16-00005. Some of LKB contributions were supported by the National Institute of Mental Health 1K01MH130244-01A1. The contents included here are the responsibility of the authors and do not represent the official views of USAID or the National Institute of Mental Health.