PrEParing for choice in a new era of HIV prevention.

In The Lancet HIV, Gonasagrie Nair and colleagues 1 Nair G Celum C Szydlo D et al. Adherence, safety, and choice of the monthly dapivirine vaginal ring or oral emtricitabine plus tenofovir disoproxil fumarate for HIV pre-exposure prophylaxis among African adolescent girls and young women: a randomised, open-label, crossover trial. Lancet HIV. 2023; (published online Oct 25.)https://doi.org/10.1016/S2352-3018(23)00227-8 Google Scholar report the findings from the MTN-34/REACH trial, which investigated the safety of, adherence to, and preferences for HIV pre-exposure prophylaxis (PrEP) among adolescent girls and young women. Conducted in three African countries, this study used a crossover design to gain new insights about PrEP use in this population. Participants aged 16–21 years agreed to take oral daily emtricitabine plus tenofovir disoproxil fumarate and use the dapivirine vaginal ring for 6 months each. The sequence of these PrEP assignments was randomly allocated, after which participants transitioned to a 6-month product choice period during which they could continue with a preferred PrEP modality or no PrEP at all. Adherence, safety, and choice of the monthly dapivirine vaginal ring or oral emtricitabine plus tenofovir disoproxil fumarate for HIV pre-exposure prophylaxis among African adolescent girls and young women: a randomised, open-label, crossover trialAdherence was moderately high and similar between oral PrEP and the dapivirine ring with favourable safety and tolerability. Oral PrEP and the dapivirine ring are effective, safe, and well tolerated HIV prevention options for adolescent girls and young women who would benefit from a choice of PrEP formulations to meet their needs and preferences. Full-Text PDF