{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:05:03Z","timestamp":1792663503457,"version":"4.5.0"},"reference-count":61,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,4,23]],"date-time":"2023-04-23T00:00:00Z","timestamp":1682208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prevention of HIV transmission is fundamental to ending the HIV epidemic. Pre\u2010exposure prophylaxis (PrEP) with oral tenofovir\u2010emtricitabine (TDF\u2010FTC) is an established HIV\u2010prevention method; however, most PrEP services in Europe have been targeted at men who have sex with men (MSM). A survey in 2021 by Women Against Viruses in Europe (WAVE) showed considerable variation in PrEP access and guidance for women throughout Europe. WAVE therefore commissioned this systematic review to provide insight into PrEP provision and barriers to uptake for women in Europe.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, and Scopus were searched for studies (January 2013\u2013May 2021) that reported on actual (e.g., efficacy and safety) or hypothetical (e.g., awareness, barriers, PrEP impact models) use of oral PrEP involving women (including cis, transgender, pregnant, migrant, and breastfeeding women). Search terms included HIV, pre\u2010exposure prophylaxis (specifically TDF\u2010FTC), and women. Studies performed outside of the World Health Organization European region were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The search identified 4716 unique citations, and 45 peer\u2010reviewed articles (44 studies) were included. The majority of these studies (34\/44 [77%]) included recipients or potential recipients of PrEP, representing 4699 women (243 transgender women). However, few studies were women focused (4\/34 [12%]) or took place outside of Western Europe (3\/34 [9%]). Across the three clinical studies that reported women\u2010specific outcomes (60 transgender women, 13 pregnant, and 19 cis women), no breakthrough infections were recorded during the use of PrEP. Lack of awareness of PrEP, low self\u2010estimation of HIV acquisition risk, concerns about stigma, lack of protection against other sexually transmitted infections, and PrEP interaction with hormones (for transgender women) were identified as barriers to use. The remaining studies examined healthcare professionals' perceptions of PrEP (9\/44 [20%]), asked for public opinion (2\/44 [5%]), or modelled the potential of PrEP for HIV prevention (1\/44 [2%]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This review revealed a notable lack of literature on PrEP for cis and transgender women in Europe. This is synonymous with a lack of PrEP provision for women in this region. Barriers to PrEP uptake are complex and rooted in institutional and societal stigma, which must be addressed at policy level. HIV prevention with PrEP is not \u2018one size fits all\u2019 and requires a nuanced gender\u2010responsive approach. Further research into the use of PrEP in cis, pregnant, breastfeeding, and transgender women is essential if we are to stop HIV transmission by 2030.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.13458","type":"journal-article","created":{"date-parts":[[2023,4,23]],"date-time":"2023-04-23T21:29:16Z","timestamp":1682285356000},"page":"765-776","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["<scp>PrEP<\/scp>\n                    for women in Europe: a systematic literature review"],"prefix":"10.1111","volume":"24","author":[{"given":"Naomi","family":"Fitzgerald","sequence":"first","affiliation":[{"name":"King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly","family":"Coltart","sequence":"additional","affiliation":[{"name":"King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6018-9026","authenticated-orcid":false,"given":"Lourdes","family":"Dominguez","sequence":"additional","affiliation":[{"name":"King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Flanagan","sequence":"additional","affiliation":[{"name":"King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Gilleece","sequence":"additional","affiliation":[{"name":"Brighton &amp; Sussex Medical School  Brighton UK"},{"name":"The Lawson Unit Royal Sussex County Hospital  Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,23]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"UNAIDS. 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