Integrating HIV prevention into women’s health care

One in five new HIV diagnoses in the United States is among women, most of whom acquire the virus through sex. A daily pill, known as pre-exposure prophylaxis (PrEP), can protect women who do not have HIV but who are at substantial risk. Previous research found that PrEP is effective for women, but its effectiveness depends on adherence.

Women’s health care providers are uniquely positioned to screen, counsel and offer PrEP. In a new commentary, UCSF Bixby researchers outline ways that obstetrician-gynecologists (ob-gyns) and other providers can integrate PrEP into standard care through:
  • Shared decision-making. This approach to counseling allows patients and clinicians to make health care decisions together based on evidence and patient experiences.
  • Incorporating women’s fertility desires and contraceptive needs. For instance, safer conception is a critical component of shared decision-making for HIV-affected couples.
  • Lessons learned from family planning and HIV prevention. These include providing information about potential side effects of a medication and how to manage them, helping women link pill-taking to other daily routines, using reminder systems and creating a support network.

Women’s health care providers can reduce the sexual transmission of HIV among US women by integrating PrEP education and provision into their practices, and by paying careful attention to women’s preferences and other factors at play in their lives.