HIV Prevention Strategies for Pregnant and Postpartum Women
Summary
Pregnant and postpartum women face heightened risk of HIV acquisition and vertical transmission due to both biological changes and social determinants. Preventive strategies encompass a combination of behavioural, biomedical and structural interventions. Key biomedical approaches include oral pre-exposure prophylaxis (PrEP) with tenofovir-based regimens, emerging long-acting modalities such as injectable cabotegravir and vaginal ring devices. These agents have been integrated into routine antenatal and postnatal care in high-burden settings, often accompanied by adherence counselling, repeat HIV testing at critical time points and partner notification services. Behavioural components focus on risk-reduction counselling, condom promotion and male partner engagement, while structural efforts aim to strengthen regulatory frameworks, improve post-marketing surveillance of drug safety and expand access through decentralised maternal and child health clinics. Globally, policies now recommend PrEP for women at substantial risk during pregnancy and breastfeeding, with implementation tailored to local epidemiology, health-system capacity and women’s preferences. Effective programmes address barriers such as stigma, pill burden and health-facility logistics, and leverage facilitators including peer support, integrated service delivery and clear communication about safety and efficacy.
Research from Nature Portfolio
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HIV Prevention Strategies for Pregnant and Postpartum Women publication trend
The graph below shows the total number of articles in hiv prevention strategies for pregnant and postpartum women across all publications each year (not limited to Nature Index journals).
Technical terms
Pre-exposure prophylaxis (PrEP): Administration of antiretroviral medication to HIV-negative individuals to prevent acquisition of HIV.
Vertical transmission: Transmission of HIV from mother to child during pregnancy, labour, delivery or breastfeeding.
Seroconversion: The development of detectable antibodies against HIV in the blood, marking transition from HIV-negative to HIV-positive status.
Antiretroviral therapy (ART): Combination of drugs used to suppress HIV replication in infected individuals; some agents are repurposed for prevention.
References
- Perinatal outcomes associated with pre-exposure prophylaxis for HIV prevention during pregnancy: a systematic review and meta-analysis. EClinicalMedicine (2024).
- Preferences and acceptability for long‐acting PrEP agents among pregnant and postpartum women with experience using daily oral PrEP in South Africa and Kenya. Journal of the International AIDS Society (2023).
- Antiretroviral Use for HIV Prevention During Pregnancy: The Need to Strengthen Regulatory and Surveillance Systems in Africa. Drug Safety (2025).
- Barriers and facilitators to uptake and use of oral pre-exposure prophylaxis in pregnant and postpartum women: a qualitative meta-synthesis. BMC Public Health (2024).
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