Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct 14;16(10):e0258542.
doi: 10.1371/journal.pone.0258542. eCollection 2021.

Adolescent girls and young women's PrEP-user journey during an implementation science study in South Africa and Kenya

Elzette Rousseau  1 , Ariana W K Katz  2 , Shannon O'Rourke  2 , Linda-Gail Bekker  1 , Sinead Delany-Moretlwe  3 , Elizabeth Bukusi  4 , Danielle Travill  3 , Victor Omollo  4 , Jennifer F Morton  5 , Gabrielle O'Malley  5 , Jessica E Haberer  6   7 , Renee Heffron  5 , Rachel Johnson  5 , Connie Celum  5 , Jared M Baeten  5   8 , Ariane van der Straten  9
Affiliations

Adolescent girls and young women's PrEP-user journey during an implementation science study in South Africa and Kenya

Elzette Rousseau et al. PLoS One. .

Abstract

Successful scale-up of PrEP for HIV prevention in African adolescent girls and young women (AGYW) requires integration of PrEP into young women's everyday lives. We conducted interviews and focus group discussions with 137 AGYW PrEP users aged 16-25 from South Africa and Kenya. Individual and relational enablers and disablers were explored at key moments during their PrEP-user journey from awareness, initiation and early use through persistence, including PrEP pauses, restarts, and discontinuation. PrEP uptake was facilitated when offered as part of an integrated sexual reproductive health service, but hampered by low awareness, stigma and misconceptions about PrEP in the community. Daily pill-taking was challenging for AGYW due to individual, relational and structural factors and PrEP interruptions (intended or unintended) were described as part of AGYW's PrEP-user journey. Disclosure, social support, adolescent-friendly health counseling, and convenient access to PrEP were reported as key enablers for PrEP persistence.

PubMed Disclaimer

Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests:JMB, LGB, CC, SD and ER received personal fees for advisory board participation from Gilead Sciences outside of this current scope of work. JMB is employed by Gilead Sciences, Inc.

Figures

Fig 1
Fig 1. AGYW’s PrEP-user journey.
Enablers and barriers at key stages in young women’s PrEP user journey from PrEP uptake to early use and persistence or discontinuation, including periods of PrEP pauses and restarts.
See this image and copyright information in PMC

References

    1. UNAIDS. Women and HIV: A spotlight on adolescent girls and young women. 2019 [Available from: https://www.unaids.org/sites/default/files/media_asset/2019_women-and-hi....
    1. UNAIDS. Global AIDS Update 2020: Seizing the moment—Tackling entrenched inequalities to end epidemics. 2020.
    1. Shisana O, Rehle T, Simbayi LC, Zuma K, Jooste S, Zungu N, et al. South African national HIV prevalence, incidence and behaviour survey, 2012. 2014. - PubMed
    1. Pettifor A, Macphail C, Anderson AD, Maman S. ’If I buy the Kellogg’s then he should [buy] the milk’: young women’s perspectives on relationship dynamics, gender power and HIV risk in Johannesburg, South Africa. Cult Health Sex. 2012;14(5):477–90. doi: 10.1080/13691058.2012.667575 - DOI - PMC - PubMed
    1. Jewkes R, Morrell R. Gender and sexuality: emerging perspectives from the heterosexual epidemic in South Africa and implications for HIV risk and prevention. Journal of the International AIDS society. 2010;13(1):6. doi: 10.1186/1758-2652-13-6 - DOI - PMC - PubMed

Publication types

Substances