PLoS ONE (Jan 2021)

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

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

DOI
https://doi.org/10.1371/journal.pone.0258542
Journal volume & issue
Vol. 16, no. 10
p. e0258542

Abstract

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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.