Adherence, Not Pregnancy Physiology, Drives Oral PrEP Efficacy

This modeling study offers Women's Health pharmacists quantitative reassurance that high oral PrEP adherence preserves near-complete protection against HIV across pregnancy and postpartum despite gestational pharmacokinetic changes.

emtricitabinetenofovir disoproxil fumaratetenofovir alafenamideF/TDFF/TAFHIV pre-exposure prophylaxisPrEPpregnancypostpartumpharmacokinetic modelingwomen's healthPURPOSE 1trial simulation Women's Health / Reproductive

Background Information

Adherence ensures high PrEP efficacy during pregnancy and postpartum.

Cisgender women are at higher risk for HIV during pregnancy, making effective pre-exposure prophylaxis (PrEP) crucial. Prophylactic efficacy of both F/TDF and F/TAF was lowest in the second trimester but exceeded 97% postpartum with high adherence. Efficacy variance suggests adherence is vital, while pregnancy-related pharmacokinetic changes minimally impact PrEP effectiveness. Adherence is key for maintaining high PrEP efficacy during pregnancy and postpartum despite pharmacokinetic changes.

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Authors: Yu Y, Brooks KM, Doncel GF, Best BM, Marzinke MA, Mirochnick M, Anderson PL, Myer L, Celum C, Heffron R, Coleman J, Davey DLJ, Zhang L, von Kleist M, Hendrix CW, Momper JD, Bies R, Scott RK

Citation: Yu Y, Brooks KM, Doncel GF, et al. Predicting Oral HIV Pre-Exposure Prophylaxis Efficacy in Cisgender Women Across Pregnancy and Postpartum. Journal of clinical pharmacology. 2026;66(9):e70278. doi:10.1002/jcph.70278

Article Links: PubMed · Journal / DOI

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Executive Summary

Study Design

Patient Population

Primary Outcomes

Secondary Outcomes & Safety Profile

Pharmacist Implications

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