Modelling study shows high efficacy of PrEP in women in countries with high HIV prevalence

In countries with high HIV prevalence, pre-exposure prophylaxis (PrEP) could reduce the infection risk in women by more than 90 percent. This is the result of a modelling study which was published in the journal Nature Medicine by an international research team lead by the Robert Koch Institute (“Model-based predictions of protective HIV pre-exposure prophylaxis adherence levels in cisgender women“). According to the scientists, there are no statistical and biological reasons that PrEP would be less effective in heterosexual women than in homosexual men.

Most HIV infections in young women occur in low-income-countries especially in Sub-Sahara Africa, with HIV prevalences of up to 25 %. For heterosexual women, PrEP with the drugs emtricitabine/tenofovir denotes one of the few ways to protect themselves against HIV. While PrEP has been used successfully in homosexual men for several years, clinical studies have shown a mixed picture regarding the effectiveness of PrEP in women, leading to a low acceptance of PrEP in women.

Based on already existing clinical trial data, the researchers first estimated the efficacy of PrEP in women. For their modelling approach, they then integrated all data sources available at that time to (in-)validate different hypotheses on the alleged different efficacy in men vs. women. The work found that PrEP could be highly effective (>90 %) in reducing the risk of HIV infection in women and constitute a major pillar of HIV prevention.

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