HIV Prevention for Black/African American Women: The Use of PrEP in the Primary Care Setting
On October 3, 2019, the United States Food and Drug Administration (FDA) approved emtricitabine 200 mg and tenofovir alafenamide 25 mg (F/TAF; Descovy®) for pre-exposure prophylaxis to reduce the risk of sexually acquired HIV in at-risk adults and adolescents weighing at least 35 kg. F/TAF is not approved for use in individuals with an increased risk of HIV from vaginal sex because its effectiveness has not been studied in this population. At this time, emtricitabine 200 mg and tenofovir disoproxil fumarate 300 mg (F/TDF; Truvada®) is the only FDA-approved medication for pre-exposure prophylaxis for this population.
For more information, refer to the FDA’s press announcement: www.fda.gov/news-events/press-announcements/fda-approves-second-drug-prevent-hiv-infection-part-ongoing-efforts-end-hiv-epidemic.
Oni J. Blackstock, MD, MHS
Bureau of HIV/AIDS Prevention and Control
NYC Department of Health and Mental Hygiene
New York, NY
Dr. Blackstock is presenting her own views and does not represent the NYC Department of Health and Mental Hygiene.
Bisola O. Ojikutu, MD, MPH
Assistant Professor of Medicine
Assistant Professor of Global Health and Social Medicine
Harvard Medical School
Associate Physician, Division of Global Health Equity
Brigham and Women’s Hospital
Stephanie Larson, PhD
Clinical Content Manager
Rebecca L. Julian, MS, ELS
Senior Manager, Editorial
Kathryn Schaefer, MSN, RN, CPHRM
Senior Manager, Accreditation and Compliance
East Lansing, MI
Stephanie S. Wenick, MPhil
Chevy Chase, MD
Upon completion, participants should be able to:
- Describe the individual, psychosocial, and structural factors contributing to HIV risk among black/African American heterosexual women in the United States
- Integrate HIV prevention, including PrEP, into the routine care of black/African American women’s reproductive and sexual health
This activity is intended for obstetrician-gynecologists, family planning providers, primary care physicians, and nurses.
Statement of Need
The Centers for Disease Control and Prevention (CDC) estimate that more than 1.1 million Americans have a substantial risk of HIV and should be offered PrEP to prevent HIV infection. Although men who have sex with men (MSM) are the largest subgroup of the high-risk population, heterosexual women—specifically, black/African American heterosexual women—represent a substantial minority of individuals for whom PrEP is warranted. However, PrEP uptake among women is estimated to be approximately 2% of the CDC target, and only one-quarter of women using PrEP are black/African American. Because PrEP has the potential to significantly reduce HIV risk when used as prescribed, it is critically important for women to be aware of their HIV risk, as well as how this self-directed prevention strategy may help them achieve their sexual health goals. It is also essential for clinicians to recognize the rationale for integrating PrEP into routine reproductive healthcare and understand how it can be successfully implemented in this setting.
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Medium/Method of Participation
This CME activity consists of a 0.75-credit online publication. To receive credit, read the introductory CME material, read the publication, and complete the post-survey, evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.
Initial Release Date: May 30, 2019
Expiration Date: May 29, 2020
Estimated Time to Complete This Activity: 45 minutes
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Oni J. Blackstock, MD, MHS, has indicated no real or apparent conflicts.
Bisola O. Ojikutu, MD, MPH, has indicated no real or apparent conflicts.
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