دورية أكاديمية
The effect of daily oral PrEP use during pregnancy on bone mineral density among adolescent girls and young women in Uganda
| العنوان: | The effect of daily oral PrEP use during pregnancy on bone mineral density among adolescent girls and young women in Uganda |
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| المؤلفون: | Kidist Zewdie, Flavia M. Kiweewa, Timothy Ssebuliba, Susan A. Morrison, Timothy R. Muwonge, Jade Boyer, Felix Bambia, Josephine Badaru, Gabrielle Stein, Kenneth K. Mugwanya, Christina Wyatt, Michael T. Yin, Andrew Mujugira, Renee Heffron |
| المصدر: | Frontiers in Reproductive Health, Vol 5 (2024) |
| بيانات النشر: | Frontiers Media S.A., 2024. |
| سنة النشر: | 2024 |
| المجموعة: | LCC:Reproduction LCC:Medicine (General) |
| مصطلحات موضوعية: | bone mineral density, oral PrEP, young women and adolescent girls, HIV prevention, Uganda, Reproduction, QH471-489, Medicine (General), R5-920 |
| الوصف: | IntroductionOral pre-exposure prophylaxis (PrEP) is recommended during pregnancy for at-risk cisgender women. Pregnancy is known to impede bone growth and tenofovir-based PrEP may also yield detrimental changes to bone health. Thus, we evaluated the effect of PrEP use during pregnancy on bone mineral density (BMD).MethodsWe used data from a cohort of women who were sexually active, HIV-negative, ages 16–25 years, initiating DMPA or choosing condoms for contraception and enrolled in the Kampala Women's Bone Study. Women were followed quarterly with rapid testing for HIV and pregnancy, PrEP dispensation, and adherence counseling. Those who became pregnant were counseled on PrEP use during pregnancy per national guidelines. BMD of the neck of the hip, total hip, and lumbar spine was measured using dual-energy x-ray absorptiometry at baseline and annually. We compared the mean percent change in BMD from baseline to month 24.ResultsAmong 499 women enrolled in the study, 105 pregnancies occurred in 90 women. At enrollment, the median age was 20 years (IQR: 19–21) and 89% initiated PrEP. During pregnancy, 67% of women continued using PrEP and PrEP was dispensed in 64% of visits. BMD declined significantly in women using PrEP during pregnancy compared to women who were not pregnant nor used PrEP: relative BMD change was −2.26% (95% CI: −4.63 to 0.11, p = 0.06) in the femoral neck, −2.57% (95% CI: −4.48 to −0.66, p = 0.01) in total hip, −3.06% (95% CI: −5.49 to −0.63, p = 0.001) lumbar spine. There was no significant difference in BMD loss when comparing PrEP-exposed pregnant women to pregnant women who never used PrEP. Women who became pregnant were less likely to continue PrEP at subsequent study visits than women who did not become pregnant (adjOR: 0.25, 95% CI: 0.16–0.37, p |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2673-3153 |
| Relation: | https://www.frontiersin.org/articles/10.3389/frph.2023.1240990/full; https://doaj.org/toc/2673-3153 |
| DOI: | 10.3389/frph.2023.1240990 |
| URL الوصول: | https://doaj.org/article/99155597461848aaa2b4f934631f5048 |
| رقم الأكسشن: | edsdoj.99155597461848aaa2b4f934631f5048 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 26733153 |
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| DOI: | 10.3389/frph.2023.1240990 |