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开始和停止暴露前预防的动机:HPTN 082试验中少女和年轻女性的经历

Motivations for Starting and Stopping PrEP: Experiences of Adolescent Girls and Young Women in the HPTN 082 Trial.

作者信息

Mills Lisa, Ndimande-Khoza Makhosazane Nomhle, Velloza Jennifer, Atujuna Millicent, Chitukuta Miria, Hosek Sybil, Chauke Hlukelo, Musara Petina, Mangxilana Nomvuyo, Mutero Prisca, Makhale Lerato Michelle, Tauya Thelma, Celum Connie, Delany-Moretlwe Sinead

机构信息

Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, 22 Esselen Street, Johannesburg, 2000, Republic of South Africa.

Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.

出版信息

AIDS Behav. 2025 Jun 3. doi: 10.1007/s10461-025-04703-0.


DOI:10.1007/s10461-025-04703-0
PMID:40457089
Abstract

Oral PrEP effectiveness depends on consistent use during periods of potential HIV exposure, but adolescent girls and young women (AGYW) find this challenging. Data on PrEP use decision-making and alignment with risk among AGYW are limited. From 2016 to 2018, we conducted in-depth interviews with participants in HPTN 082, an open-label PrEP study in South Africa and Zimbabwe, to explore reasons for PrEP starts, stops, and restarts. Of 60 PrEP acceptors, 12 delayed acceptance, 15 used PrEP intermittently, 18 paused and restarted PrEP, and 13 permanently discontinued PrEP during 12-month follow-up. Perceived HIV vulnerability motivated PrEP start, but there was little evidence that fluctuating risk perception motivated prevention-effective use. PrEP stops were motivated by stigma, misconceptions and side effects; PrEP restarts were prompted by support from family, peers and clinic staff. Decision-making was related to social, gendered and normative influences, highlighting opportunities for psycho-educational support and multimedia campaigns to normalise HIV prevention.

摘要

口服暴露前预防(PrEP)的有效性取决于在潜在的艾滋病毒暴露期间持续使用,但青春期女孩和年轻女性(AGYW)发现这具有挑战性。关于AGYW使用PrEP的决策以及与风险匹配的数据有限。2016年至2018年,我们对参与HPTN 082研究的参与者进行了深入访谈,HPTN 082是一项在南非和津巴布韦开展的开放标签PrEP研究,旨在探究开始、停止和重新开始使用PrEP的原因。在60名接受PrEP的人中,12人延迟接受,15人间歇性使用PrEP,18人暂停并重新开始使用PrEP,13人在12个月的随访期间永久停止使用PrEP。感知到的艾滋病毒易感性促使开始使用PrEP,但几乎没有证据表明风险认知的波动促使采取有效的预防措施。停止使用PrEP的原因是耻辱感、误解和副作用;重新开始使用PrEP是受到家人、同伴和诊所工作人员支持的推动。决策与社会、性别和规范影响有关,这凸显了开展心理教育支持和多媒体宣传活动以使艾滋病毒预防常态化的机会。

相似文献

[1]
Motivations for Starting and Stopping PrEP: Experiences of Adolescent Girls and Young Women in the HPTN 082 Trial.

AIDS Behav. 2025-6-3

[2]
Measuring Pre-Exposure Prophylaxis (PrEP) Stigma Among Adolescent Girls and Young Women in Western Kenya: Scale Development, Validation, and Associations with PrEP Adherence.

AIDS Patient Care STDS. 2025-8

[3]
How a menu of adherence support strategies facilitated high adherence to HIV prevention products among adolescent girls and young women in sub-Saharan Africa: a mixed methods analysis.

J Int AIDS Soc. 2023-11

[4]
Depression Among Pregnant and Breastfeeding Persons Participating in Two Randomized Trials of the Dapivirine Vaginal Ring and Oral Pre-Exposure Prophylaxis (PrEP) in Malawi, South Africa, Uganda, and Zimbabwe.

AIDS Behav. 2024-7

[5]
Acceptability and Feasibility of Remote PrEP Visits for Adolescent Girls and Young Women in South Africa.

AIDS Behav. 2025-5-13

[6]
Transforming PrEP marketing: understanding the place of PrEP in the hearts and minds of adolescent girls and young women in sub-Saharan Africa.

J Int AIDS Soc. 2025-7

[7]
PrEP choice in the real world: Results of a prospective cohort study describing uptake and use patterns of oral PrEP and the dapivirine vaginal ring among women in sub-Saharan Africa.

J Int AIDS Soc. 2025-7

[8]
Centering autonomy and choice to support oral PrEP utilization among people who inject drugs: qualitative lessons from HPTN 094 INTEGRA.

Addict Sci Clin Pract. 2024-12-18

[9]
Interest in I-PrEP and Willingness to Participate in Clinical Trials Among Men and Transfeminine Persons Who have Sex with Men in Sub-Saharan Africa: Quantitative and Qualitative Findings from HPTN 075.

AIDS Behav. 2024-7

[10]
Mobile Health Intervention Tools Promoting HIV Pre-Exposure Prophylaxis Among Adolescent Girls and Young Women in Sub-Saharan Africa: Scoping Review.

JMIR Mhealth Uhealth. 2025-6-20

本文引用的文献

[1]
Pre-exposure prophylaxis access, uptake and usage by young people: a systematic review of barriers and facilitators.

Ther Adv Infect Dis. 2024-12-7

[2]
High study participation but diverging adherence levels: qualitatively unpacking PrEP use among adolescent girls and young women over two years in Eastern Cape, South Africa.

J Behav Med. 2024-4

[3]
Family influences on oral PrEP use among adolescent girls and young women in Kenya and South Africa.

PLoS One. 2023

[4]
Adherence, safety, and choice of the monthly dapivirine vaginal ring or oral emtricitabine plus tenofovir disoproxil fumarate for HIV pre-exposure prophylaxis among African adolescent girls and young women: a randomised, open-label, crossover trial.

Lancet HIV. 2023-12

[5]
The Effect of Disclosure of PrEP Use on Adherence Among African Young Women in an Open-Label PrEP Study: Findings from HPTN 082.

AIDS Behav. 2024-5

[6]
Factors that influence adolescent girls and young women's re-initiation or complete discontinuation from daily oral PrEP use: a qualitative study from Eastern Cape Province, South Africa.

J Int AIDS Soc. 2023-9

[7]
A decision support tool has similar high PrEP uptake and increases early PrEP persistence in adolescent girls and young women in South Africa: results from a randomized controlled trial.

J Int AIDS Soc. 2023-8

[8]
"I know why I am taking this pill": Young women navigation of disclosure and support for PrEP uptake and adherence in Eastern Cape Province, South Africa.

PLOS Glob Public Health. 2023-1-20

[9]
Psychosocial determinants of pre-exposure prophylaxis use among pregnant adolescent girls and young women in Cape Town, South Africa: A qualitative study.

Int J STD AIDS. 2023-7

[10]
Uptake of and adherence to oral pre-exposure prophylaxis among adolescent girls and young women at high risk of HIV-infection in Kampala, Uganda: A qualitative study of experiences, facilitators and barriers.

BMC Womens Health. 2022-11-10

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