Hsu Allison, Falcao Joana, Zandamela Ricardino, Zerbe Allison, Zech Jennifer M, de Gusmao Eduarda Pimentel, Stephanz Elizabeth, Vitale Mirriah, Abrams Elaine J
ICAP at Columbia University, New York, New York, United States of America.
ICAP at Columbia University, Maputo, Mozambique.
PLOS Glob Public Health. 2025 Jun 16;5(6):e0004746. doi: 10.1371/journal.pgph.0004746. eCollection 2025.
Despite widespread availability of ART and PrEP, HIV incidence among adolescent girls and young women (AGYW) in Mozambique remains amongst the highest in Africa. Similarly, modern contraception methods are broadly available in the public sector, but high rates of unplanned pregnancies persist. We explored AGYW's sexual behavior and knowledge of sexual and reproductive health, and HIV prevention practices in Nampula, Mozambique. Between May-June 2022, we conducted a cross-sectional survey among a convenience sample of AGYW 15-25 years whose self-reported HIV status was negative or unknown receiving care at three adolescent health clinics in Nampula province. Information on demographics, sexual behavior, HIV, and contraception and PrEP knowledge and attitudes was collected. Responses were analyzed using descriptive statistics. Of 200 AGYW (median age: 19 years, interquartile range: 17-21.3 years), 55% were in school, 32% completed secondary school and 81% had never been employed. Overall, 77% reported ever having had sex and 26% reported being <16 years at first sex. Nearly all respondents knew about condoms; only half had used a condom at last sex. Male condoms (62%), withdrawal (35%), and implants (25%) were the most commonly previously used contraceptive methods. AGYW were most interested in trying implants (18%), injectables (12%), and the pill (11%), though 31% reported not being interested in trying any new contraceptive method. Respondents had accurate general HIV knowledge; only 26% reported had ever heard of PrEP and 2% reported previous use. However, 64% expressed interest in using PrEP daily pills and 76% in long-acting injectables. AGYW in Nampula reported low usage of modern contraceptive methods and poor knowledge of PrEP. AGYW expressed interest in trying contraception and PrEP and showed positive attitudes toward PrEP usage. More widespread education around family planning and HIV prevention is needed to reduce barriers around improving sexual health among AGYW in Mozambique.
尽管抗逆转录病毒疗法（ART）和暴露前预防（PrEP）广泛可得，但莫桑比克青春期女孩和年轻女性（AGYW）中的艾滋病毒发病率仍位居非洲最高之列。同样，现代避孕方法在公共部门广泛提供，但意外怀孕率仍然很高。我们在莫桑比克楠普拉探讨了AGYW的性行为、性与生殖健康知识以及艾滋病毒预防措施。2022年5月至6月期间，我们对楠普拉省三家青少年健康诊所中自我报告艾滋病毒状况为阴性或未知且正在接受护理的15至25岁AGYW便利样本进行了横断面调查。收集了有关人口统计学、性行为、艾滋病毒、避孕以及PrEP知识和态度的信息。使用描述性统计分析了回答。在200名AGYW（中位年龄：19岁，四分位间距：17 - 21.3岁）中，55%在上学，32%完成了中学学业，81%从未就业。总体而言，77%报告曾有过性行为，26%报告首次性行为时年龄小于16岁。几乎所有受访者都知道避孕套；只有一半在最近一次性行为时使用了避孕套。男性避孕套（62%）、体外射精（35%）和宫内节育器（25%）是最常用的避孕方法。AGYW对尝试宫内节育器（18%）、注射剂（12%）和避孕药（11%）最感兴趣，不过31%报告对尝试任何新的避孕方法不感兴趣。受访者对艾滋病毒有准确的一般知识；只有26%报告听说过PrEP，2%报告曾使用过。然而，64%表示有兴趣使用PrEP每日药丸，76%对长效注射剂感兴趣。楠普拉的AGYW报告现代避孕方法使用率低且对PrEP了解不足。AGYW表示有兴趣尝试避孕和PrEP，并对PrEP的使用表现出积极态度。需要更广泛地开展围绕计划生育和艾滋病毒预防的教育，以减少莫桑比克AGYW改善性健康方面的障碍。
