Willingness of adolescent girls and young women to participate in future clinical trials of long-acting PrEP implants for HIV prevention, Kampala Uganda

Abstract

Adolescent girls and young women (AGYW) continue to face a significant risk of HIV infection, particularly as numerous experimental prevention products are in development. This study assessed the willingness to participate (WTP) in future clinical trials of long-acting HIV pre-exposure prophylaxis (PrEP) implants among AGYW at high risk of HIV infection in Kampala, Uganda. From January to October 2019, we conducted a cross-sectional study among AGYW aged 14-24 years. Interviewers _collected data on socio-demographics, substance use, sexual behavioural risk, contraceptive use and laboratory diagnosis of sexually transmitted infections (STIs). Participants were asked about their WTP in future clinical trials of a long-acting PrEP (LAP) implant. Multivariable logistic regression models were fitted to determine participant characteristics associated with WTP in future clinical trials of a PrEP implant. We enrolled 285 participants, with a median age of 20 years. Among them, 57.2% were single, 54.7% had completed at least secondary education, 92.6% engaged in transactional sex, 36.5% had multiple new male partners, 25.3% tested positive for STIs (chlamydia or gonorrhoea), and 15.4% reported drug use in the past three months. Nearly half (45.6%) of the AGYW expressed willingness to participate in a future HIV prevention study involving the LAP implant. Willingness to participate in a future HIV prevention study involving the LAP implant was higher among those with multiple new male partners (adjusted odds ratio [aOR] 1.84, 95%CI 1.09-3.11, P = 0.022) and those using contraceptives (aOR 1.69, 95% CI 1.00-2.85, P = 0.047) but lower among those with higher income levels (aOR 0.46, 95%CI 0.25-0.84, P = 0.013). These findings suggest that AGYW with higher HIV risk and those with prior contraceptive experience could potentially participate in future clinical trials of the LAP implant.

Fig 1. The inclusion and exclusion criteria of adolescent girls and young women (AGYW) for willingness to participate in future clinical trials of long-acting PrEP implant (LAP).

Fig 2. Reasons for the AGYW willing to participate (WTP) in future clinical trials of long-acting PrEP implant.

Fig 3. Reasons of AGYW not willing to participate in future clinical trials of long-acting PrEP implant.