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Clinical Trial
. 2025 Apr 23;15(4):e086742.
doi: 10.1136/bmjopen-2024-086742.

HIV risk perception, trust and PrEP adherence among participants in an HIV prevention trial: a qualitative longitudinal study, South Africa

Rujeko Samanthia Chimukuche  1   2 , Londiwe Shandu  3 , Silindile Zulu  3 , Phindile Khanyile  3 , Nishanta Singh  4 , Zakir Gaffoor  4 , Rachel Kawuma  5 , Sheena McCormack  6 , Janet Seeley  3   7 ; PrEPVacc Study Group
Collaborators, Affiliations
Clinical Trial

HIV risk perception, trust and PrEP adherence among participants in an HIV prevention trial: a qualitative longitudinal study, South Africa

Rujeko Samanthia Chimukuche et al. BMJ Open. .

Abstract

Introduction: Ensuring the effectiveness of HIV prevention and treatment methods requires high levels of adherence. Studies have recognised the significance of trust in shaping HIV risk perception.

Aim: In this qualitative analysis, our aim was to explore risk perceptions and understand how individuals assess and respond to HIV risks, as well as their uptake and adherence to oral pre-exposure prophylaxis (PrEP).

Setting: The study was based on the setting of an HIV prevention trial conducted in South Africa.

Methods: Thirty individuals, 9% of the total clinical trial participants, enrolled in the clinical trial were purposively selected and interviewed at three time points within the trial during the follow-up phase. Data analysis was conducted using the Trust, Confidence and Cooperation framework that included constructs of trust, confidence and cooperation.

Results: The findings show that the ongoing participation in the clinical trial played a significant role in influencing participants' decision to continue PrEP as HIV prevention. This decision was grounded in their trust that PrEP would effectively reduce their vulnerability to HIV and infection.

Conclusion: Clear and consistent health-promoting initiatives enhance participants' self-awareness of HIV risks and promote understanding (uptake) and effectiveness of HIV prevention methods.

Trial registration number: NCT04066881.

Keywords: HIV & AIDS; Health; Public health; QUALITATIVE RESEARCH.

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Conflict of interest statement

Competing interests: None declared.

References

    1. World Health Organisation . Policy brief: WHO expands recommendation on oral pre-exposure prophylaxis of HIV infection (PrEP) Geneva: World Health Organisation; 2015.
    1. World Health Organisation Global health programme: pre-exposure prophylaxis (PrEP) [01-Mar-2024]. https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/p... Available. Accessed.
    1. World Health Organisation What’s the 2+1+1? Event-driven oral pre-exposure prophylaxis to prevent HIV for men who have sex with men: update to WHO’s recommendation on oral PrEP. 2019. [10-Sep-2023]. https://www.who.int/publications/i/item/what-s-the-2-1-1-event-driven-or... Available. Accessed.
    1. PrEPWatch Exploring data and information on PrEP across the globe. 2024. [01-Mar-2024]. https://www.prepwatch.org Available. Accessed.
    1. Joint United Nations Programme on HIV/AIDS and the World Health Organization . Ethical considerations in HIV prevention trials. Geneva: WHO; 2021.

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