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乌干达坎帕拉青少年女孩和年轻女性参与长效HIV预防暴露前预防植入剂未来临床试验的意愿。

Willingness of adolescent girls and young women to participate in future clinical trials of long-acting PrEP implants for HIV prevention, Kampala Uganda.

作者信息

Lunkuse Jane Frances, Sseremba Grace Godfrey, Chetty-Makkan Candice, Wahome Elizabeth, Price Matt A, Mayanja Yunia

机构信息

Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.

Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

PLOS Glob Public Health. 2025 Aug 8;5(8):e0005028. doi: 10.1371/journal.pgph.0005028. eCollection 2025.

Abstract

Adolescent girls and young women (AGYW) continue to face a significant risk of HIV infection, particularly as numerous experimental prevention products are in development. This study assessed the willingness to participate (WTP) in future clinical trials of long-acting HIV pre-exposure prophylaxis (PrEP) implants among AGYW at high risk of HIV infection in Kampala, Uganda. From January to October 2019, we conducted a cross-sectional study among AGYW aged 14-24 years. Interviewers _collected data on socio-demographics, substance use, sexual behavioural risk, contraceptive use and laboratory diagnosis of sexually transmitted infections (STIs). Participants were asked about their WTP in future clinical trials of a long-acting PrEP (LAP) implant. Multivariable logistic regression models were fitted to determine participant characteristics associated with WTP in future clinical trials of a PrEP implant. We enrolled 285 participants, with a median age of 20 years. Among them, 57.2% were single, 54.7% had completed at least secondary education, 92.6% engaged in transactional sex, 36.5% had multiple new male partners, 25.3% tested positive for STIs (chlamydia or gonorrhoea), and 15.4% reported drug use in the past three months. Nearly half (45.6%) of the AGYW expressed willingness to participate in a future HIV prevention study involving the LAP implant. Willingness to participate in a future HIV prevention study involving the LAP implant was higher among those with multiple new male partners (adjusted odds ratio [aOR] 1.84, 95%CI 1.09-3.11, P = 0.022) and those using contraceptives (aOR 1.69, 95% CI 1.00-2.85, P = 0.047) but lower among those with higher income levels (aOR 0.46, 95%CI 0.25-0.84, P = 0.013). These findings suggest that AGYW with higher HIV risk and those with prior contraceptive experience could potentially participate in future clinical trials of the LAP implant.

摘要

青少年女孩和年轻女性(AGYW)仍然面临着感染艾滋病毒的重大风险,尤其是在众多实验性预防产品正在研发的情况下。本研究评估了乌干达坎帕拉艾滋病毒感染高危的AGYW参与长效艾滋病毒暴露前预防(PrEP)植入物未来临床试验的意愿。2019年1月至10月,我们对14至24岁的AGYW进行了一项横断面研究。访谈者收集了社会人口统计学、物质使用、性行为风险、避孕措施使用以及性传播感染(STIs)实验室诊断等方面的数据。参与者被问及他们参与长效PrEP(LAP)植入物未来临床试验的意愿。采用多变量逻辑回归模型来确定与PrEP植入物未来临床试验中参与意愿相关的参与者特征。我们招募了285名参与者,中位年龄为20岁。其中,57.2%为单身,54.7%至少完成了中等教育,92.6%从事交易性行为,36.5%有多个新男性伴侣,25.3%性传播感染(衣原体或淋病)检测呈阳性,15.4%报告在过去三个月内有吸毒行为。近一半(45.6%)的AGYW表示愿意参与涉及LAP植入物的未来艾滋病毒预防研究。在有多个新男性伴侣的人群(调整后的优势比[aOR]为1.84,95%置信区间[CI]为1.09 - 3.11,P = 0.022)和使用避孕措施的人群(aOR为1.69,95% CI为1.00 - 2.85,P = 0.047)中,参与涉及LAP植入物的未来艾滋病毒预防研究的意愿较高,但在收入水平较高的人群中较低(aOR为0.46,95% CI为0.25 - 0.84,P = 0.013)。这些发现表明,艾滋病毒风险较高的AGYW以及有避孕经验的人群可能会参与LAP植入物的未来临床试验。

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