J Assoc Nurses AIDS Care. 2020 Nov-Dec;31(6):669-677. doi: 10.1097/JNC.0000000000000191.
Adolescent girls and young women (AGYW) in sub-Saharan Africa have high HIV incidence. Despite scale-up of programmatic delivery and demand creation activities in this population, pre-exposure prophylaxis (PrEP) uptake is low. To explore community perceptions around AGYW PrEP use, we conducted four focus group discussions (FGDs) between October and December 2018 with 26 Community Advisory Board (CAB) members in Kenya. Conventional content analysis and thematic network analysis were used to identify themes relating to community perceptions of PrEP use among AGYW. CAB members noted community perception of PrEP use as unacceptable for AGYW because of the potential to increase “promiscuous” behavior, STIs, and pregnancy. AGYW may face stigma if PrEP is mistaken for HIV treatment, and may fear HIV testing or accessing PrEP because of a lack of youth-friendly services. PrEP can be integrated into maternal and child health and family planning clinics, which are routinely accessed by AGYW and lack the stigma associated with HIV clinics. PrEP scale-up among AGYW will require continued community sensitization to address concerns, reduce stigma, and clarify misperceptions.
撒哈拉以南非洲的青少年女孩和年轻女性（AGYW）HIV 感染率很高。尽管在该人群中扩大了方案的提供和需求创造活动，但暴露前预防（PrEP）的采用率仍然很低。为了探讨社区对 AGYW PrEP 使用的看法，我们于 2018 年 10 月至 12 月期间在肯尼亚与 26 名社区咨询委员会（CAB）成员进行了 4 次焦点小组讨论（FGD）。采用常规内容分析和主题网络分析，确定了与社区对 AGYW 使用 PrEP 的看法相关的主题。CAB 成员认为，由于 PrEP 可能会增加“滥交”行为、性传播感染和怀孕的风险，因此 AGYW 使用 PrEP 是不可接受的。如果 PrEP 被误认为是 HIV 治疗，AGYW 可能会面临污名化，并且由于缺乏适合年轻人的服务，可能会害怕接受 HIV 检测或使用 PrEP。PrEP 可以整合到母婴健康和计划生育诊所中，这些诊所是 AGYW 经常光顾的地方，而且没有与 HIV 诊所相关的污名。要在 AGYW 中扩大 PrEP 的使用范围，需要继续进行社区宣传，以解决关切问题、减少污名化并澄清误解。
