Awareness of Heightened Sexual and Behavioral Vulnerability as a Trigger for PrEP Resumption Among Adolescent Girls and Young Women in East and Southern Africa
- PMID: 38051383
- PMCID: PMC10719120
- DOI: 10.1007/s11904-023-00680-y
Awareness of Heightened Sexual and Behavioral Vulnerability as a Trigger for PrEP Resumption Among Adolescent Girls and Young Women in East and Southern Africa
Abstract
Purpose of review: East and Southern Africa are the epicenter of the HIV epidemic. High HIV incidence rates among adolescent girls and young women (AGYW) remain stable over the last decade despite access to daily oral PrEP. Some settings have experienced high PrEP uptake among AGYW; however, discontinuation has been high. This review sought to understand drivers of PrEP discontinuation in this population in order to identify potential mechanisms to facilitate PrEP restart and optimize PrEP use.
Recent findings: Drivers of PrEP discontinuation included low perceived HIV acquisition risk, PrEP-associated side effects, pill burden, family/sexual partner disapproval, lack of/intermittent sexual activity, PrEP use stigma, fear of intimate partner violence, misinformation about long-term PrEP use, and limited/inconsistent access to PrEP. The most frequently reported driver of PrEP discontinuation was low perceived HIV acquisition risk. This indicates that innovative interventions to help AGYW recognize their HIV risk and make informed decisions about PrEP use are urgently needed.
Keywords: Adolescents; HIV vulnerability; Oral PrEP; Restart.
© 2023. The Author(s).
Conflict of interest statement
K. Reddy, Prof. Renee Heffron and Prof. Thesla Palanee-Phillips declare that they have no conflict of interest.
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References
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- What we do: HIV & AIDS. United nations population fund East and Southern Africa Regional Office (UNFPA ESARO). https://esaro.unfpa.org/en/topics/hiv-aids. Accessed 28 Mar 2023.
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- Miles to Go - The Response to HIV in Eastern and Southern Africa. Global AIDS Update. 2018. https://www.unaids.org/sites/default/files/media_asset/miles-to-go_easte.... Accessed 5 Oct 2023.
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- Heffron R, Ngure K, Odoyo J, Bulya N, Tindimwebwa E, Hong T, et al. Pre-exposure prophylaxis for HIV-negative persons with partners living with HIV: uptake, use, and effectiveness in an open-label demonstration project in East Africa. Gates Open Res. 2017;1:3. doi: 10.12688/gatesopenres.12752.1. - DOI - PMC - PubMed
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