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