Adolescent Girls and Young Women Overcoming Adherence Challenges with Vaginal and Oral PrEP Use: A Longitudinal Qualitative Study from a Crossover Trial in South Africa, Uganda, and Zimbabwe.
Adherence support
Adolescent girls and young women
HIV prevention
Pre-exposure prophylaxis
Qualitative
Sub-Saharan Africa
Journal
AIDS and behavior
ISSN: 1573-3254
Titre abrégé: AIDS Behav
Pays: United States
ID NLM: 9712133
Informations de publication
Date de publication:
30 Sep 2024
30 Sep 2024
Historique:
accepted:
07
09
2024
medline:
30
9
2024
pubmed:
30
9
2024
entrez:
29
9
2024
Statut:
aheadofprint
Résumé
Rates of HIV acquisition remain high among adolescent girls and young women (AGYW) in sub-Saharan Africa. We explored South African, Ugandan, and Zimbabwean AGYW's experiences in a crossover trial of two HIV prevention products: Daily oral pre-exposure prophylaxis pills and a monthly dapivirine vaginal ring. A subset of participants (n = 25) across all sites completed up to three serial in-depth interviews (SIDIs). The SIDIs explored barriers to product use, coping strategies, and the resulting outcomes. Coded textual data were analyzed using a product acceptability conceptual framework. Participants in the SIDIs described managing the array of challenges they encountered through formal adherence support, strategic product disclosure, and personally adapted strategies. For both products, perceived discreetness of the product and decision-making around disclosure was an important component of participants' narratives. Participants tailored their coping strategies based on available personal resources (e.g., cell phone alarms for PrEP reminders, social support through disclosure) or study provided resources (e.g., encouragement from staff, adherence groups). Notably, challenges participants encountered with each product during the crossover period helped inform product selection during the choice period. Our findings suggest that-even in a context where AGYW have access to several options for HIV prevention-challenges to consistent product use remain, but accessible support mechanisms and informed choice can help mitigate these challenges. Enacting that choice may also empower AGYW to reach their short and long-term life goals-including for HIV prevention. (NCT03593655, 20th July 2018).
Identifiants
pubmed: 39343865
doi: 10.1007/s10461-024-04503-y
pii: 10.1007/s10461-024-04503-y
doi:
Banques de données
ClinicalTrials.gov
['NCT03593655']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : National Institute of Allergy and Infectious Diseases
ID : UM1AI068633
Organisme : National Institute of Allergy and Infectious Diseases
ID : UM1AI068615
Organisme : National Institute of Allergy and Infectious Diseases
ID : UM1AI106707
Informations de copyright
© 2024. The Author(s).
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