Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; PolicyLab, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Craig Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
J Adolesc Health. 2021 Nov;69(5):824-830. doi: 10.1016/j.jadohealth.2021.04.031. Epub 2021 Jun 5.
HIV pre-exposure prophylaxis (PrEP) reduces HIV transmission and is approved for adolescents aged 12-17 years. Adolescent girls and young women (AGYW) have modest PrEP uptake rates, while many receive reproductive health counseling. We sought to identify opportunities for incorporating PrEP education in contraceptive counseling delivered to AGYW.
We performed a secondary analysis of data from the Health Coaching for Contraceptive Continuation pilot study, which supported contraceptive use among AGYW. Participants were 14-22 years old, sexually active with males, and not desiring pregnancy within 12 months. Coaches were sexual health educators with ≥5 years' experience providing contraceptive and PrEP counseling to youth. Participants completed a baseline visit within 30 days of contraceptive initiation and completed up to five monthly coaching sessions. Of 33 enrollees, this analysis includes the 21 who completed ≥4 sessions. Two coders deductively coded session transcripts for five themes: opportunities to discuss PrEP; HIV knowledge, risk perception, and testing attitudes; changes in HIV risk status; condom use knowledge and skills; and sexually transmitted infection knowledge and risk perception.
Of the 111 transcripts coded, 24 contained opportunities to discuss PrEP and were inductively analyzed. Thematic analysis demonstrated three types of opportunities for PrEP discussions: failure to introduce information, and provision of incomplete information or misinformation. Analysis also revealed four opportunity contexts: sexually transmitted infection prevention strategies, HIV risk reduction, avoidance of adverse sexual health outcomes, and disclosures of condom nonprotected sexual behaviors. Only one transcript mentioned PrEP.
Multiple opportunities to introduce PrEP counseling exist within contraceptive counseling provided to AGYW.
艾滋病毒暴露前预防（PrEP）可降低艾滋病毒传播率，已获准用于 12-17 岁青少年。少女和年轻女性（AGYW）接受 PrEP 的比例较低，而许多人接受了生殖健康咨询。我们试图确定在向 AGYW 提供的避孕咨询中纳入 PrEP 教育的机会。
我们对“避孕延续健康辅导”试点研究的数据进行了二次分析，该研究支持 AGYW 使用避孕措施。参与者年龄在 14-22 岁之间，与男性发生过性行为，且在 12 个月内不希望怀孕。辅导员是性健康教育工作者，具有≥5 年为年轻人提供避孕和 PrEP 咨询的经验。参与者在开始避孕后 30 天内完成基线访问，并完成最多五次每月辅导课程。在 33 名入组者中，本分析包括完成≥4 次课程的 21 名参与者。两名编码员对 111 次会话记录进行了演绎编码，这些记录涵盖了五个主题：讨论 PrEP 的机会；HIV 知识、风险感知和检测态度；HIV 风险状况的变化； condom 使用知识和技能；以及性传播感染知识和风险感知。
在编码的 111 次记录中，有 24 次记录包含讨论 PrEP 的机会，并进行了归纳分析。主题分析显示了讨论 PrEP 的三种机会类型：未能引入信息，以及提供不完整信息或错误信息。分析还揭示了四个机会背景：性传播感染预防策略、HIV 风险降低、避免不良性健康后果和披露 condom 无保护性行为。只有一份记录提到了 PrEP。
在向 AGYW 提供的避孕咨询中，存在多种引入 PrEP 咨询的机会。
