Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, 22 Esselen Street, Hillbrow, Johannesburg, 2001, South Africa.
International Center for Research on Women, Washington, DC, USA.
BMC Public Health. 2020 Jun 26;20(1):1016. doi: 10.1186/s12889-020-09115-4.
Daily oral pre-exposure prophylaxis (PrEP) can reduce HIV infection in adolescent girls and young women if used consistently during periods of risk. The EMPOWER study evaluated peer-based clubs incorporating an empowerment curriculum offered to adolescent girls and young women (16-24 years) in South Africa and Tanzania for adherence support.
Using serial in-depth interviews (n = 33), we assessed the benefits and challenges of club attendance among 13 EMPOWER participants in the Johannesburg site who were randomised to clubs. We used a summary matrix of coded data to support a narrative, case-based analysis. Four case studies are presented.
Club participants reported benefits such as increased self-esteem and self-efficacy, reduced isolation, and greater insight into gender-based violence and strategies to address it. Day-to-day PrEP adherence was not the only topic discussed in clubs; participants also appreciated the safe space for sharing problems (such as relationship conflict and PrEP stigma) and found interactive exercises helpful in improving partner communication.
Findings support the use of peer-based clubs using a structured empowerment approach, which may offer valuable PrEP initiation support to adolescent girls and young women in settings with high HIV and gender-based violence prevalence.
Pan African Clinical Trials Registry PACTR202006754762723 , 5 April 2020, retrospectively registered.
如果在有风险的时期内持续使用，每日口服暴露前预防（PrEP）可以减少青少年女孩和年轻女性中的 HIV 感染。EMPOWER 研究评估了在南非和坦桑尼亚为青少年女孩和年轻女性（16-24 岁）提供的基于同伴的俱乐部，其中纳入了赋权课程，以提供坚持使用的支持。
我们使用连续的深入访谈（n=33），评估了在约翰内斯堡随机分配到俱乐部的 13 名 EMPOWER 参与者参加俱乐部的收益和挑战。我们使用编码数据的摘要矩阵来支持叙述性、基于案例的分析。呈现了四个案例研究。
俱乐部参与者报告了一些好处，例如自尊心和自信心增强、减少孤立感，以及对基于性别的暴力和解决策略的更深入了解。俱乐部中不仅讨论了日常 PrEP 坚持的问题；参与者还欣赏到了分享问题（如关系冲突和 PrEP 耻辱感）的安全空间，并发现互动练习有助于改善伴侣沟通。
研究结果支持使用基于同伴的俱乐部采用结构化赋权方法，这可能为高 HIV 和基于性别的暴力流行环境中的青少年女孩和年轻女性提供宝贵的 PrEP 起始支持。
泛非临床试验注册处 PACTR202006754762723 ，2020 年 4 月 5 日，回顾性注册。
