The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.
Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA.
AIDS Behav. 2022 Nov;26(11):3726-3739. doi: 10.1007/s10461-022-03702-9. Epub 2022 Jun 2.
Home-based service delivery has been used to improve access to HIV testing and antiretroviral initiation across sub-Saharan Africa, but it has yet to be leveraged to improve pre-exposure prophylaxis (PrEP) uptake. We interviewed 37 adolescent girls and young women (AGYW) in Eastern Cape, South Africa to explore why they chose to initiate PrEP or not following home-based HIV testing and referral for PrEP, and what influenced time to PrEP initiation. Participants reported that home visits provided a source of trusted information and a way to involve family members in their PrEP initiation decisions, motivating some to start PrEP. AGYW who initiated PrEP were more likely to qualitatively perceive themselves to be at high risk for HIV compared with those who never initiated PrEP. Integrating home-based HIV testing with PrEP education and referral may be a valuable way to reduce familial barriers and boost PrEP uptake among AGYW in South Africa. Trial registration: NCT03977181. Retrospectively registered on June 6, 2019.
家庭为基础的服务模式已被用于改善撒哈拉以南非洲的艾滋病毒检测和抗逆转录病毒药物的初始治疗的可及性，但尚未利用这一模式来提高暴露前预防（PrEP）的使用率。我们在南非东开普省采访了 37 名青少年女孩和年轻妇女（AGYW），以探讨为什么她们在接受家庭为基础的 HIV 检测和 PrEP 转介后选择开始 PrEP 治疗或不开始 PrEP 治疗，以及哪些因素影响了开始 PrEP 治疗的时间。参与者报告说，家访提供了可靠信息的来源，并为他们的 PrEP 启动决策让家庭成员参与其中提供了一种方式，这促使一些人开始使用 PrEP。与从未开始 PrEP 的人相比，开始 PrEP 的 AGYW 更有可能定性地认为自己有感染艾滋病毒的高风险。将家庭为基础的 HIV 检测与 PrEP 教育和转介相结合，可能是减少家庭障碍和提高南非 AGYW 中 PrEP 使用率的一种有价值的方法。试验注册：NCT03977181。于 2019 年 6 月 6 日回顾性注册。
