title: Biomedical HIV Prevention Including Pre-exposure Prophylaxis and Opiate Agonist Therapy for Women Who Inject Drugs: State of Research and Future Directions.
abstract: Women who inject drugs (WWID) are at higher risk of HIV compared with their male counterparts as a result of multiple factors, including biological, behavioral, and sociostructural factors, yet comparatively little effort has been invested in testing and delivering prevention methods that directly target this group. In this article, we discuss the need for expanded prevention interventions for WWID, focusing on 2 safe, effective, and approved, yet underutilized biomedical prevention methods: opiate agonist therapy (OAT) and oral pre-exposure prophylaxis (PrEP). Although both interventions are well researched, they have not been well examined in the context of gender. We discuss the drivers of women injectors' higher HIV risk, review the effectiveness of OAT and PrEP interventions among women, and explain why these new HIV prevention tools should be prioritized for WWID. There is substantial potential for impact of OAT and PrEP programs for WWID in the context of broader gender-responsive HIV prevention initiatives. Although awaiting efficacy data on other biomedical approaches in the HIV prevention research "pipeline," we propose that the scale-up and implementation of these proven, safe, and effective interventions are needed now.
authors.affiliation: *Department of Internal Medicine, Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM; †Department of Medicine, University of Washington, Seattle, WA; ‡Kirby Institute for Infection and Immunity, UNSW Australia, Sydney, Australia; §Bangkok Tenofovir Study Group, Taksin Hospital, Bangkok, Thailand; ‖HIV Clinical Research, Thailand MOPH, U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand; ¶Department of Global Health and Medicine, University of Washington, Seattle, WA; and #HIV Clinical Research, Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, GA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Page
authors.forename: Judith
authors.initials: J
authors.lastname: Tsui
authors.forename: Lisa
authors.initials: L
authors.lastname: Maher
authors.forename: Kachit
authors.initials: K
authors.lastname: Choopanya
authors.forename: Suphak
authors.initials: S
authors.lastname: Vanichseni
authors.forename: Philip A
authors.initials: PA
authors.lastname: Mock
authors.forename: Connie
authors.initials: C
authors.lastname: Celum
authors.forename: Michael
authors.initials: M
authors.lastname: Martin
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D009313:National Health Programs; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D065129:Pre-Exposure Prophylaxis; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000188:drug therapy*; D014932:Women's Health Services
chemical_list: D000701:Analgesics, Opioid