Awareness of Heightened Sexual and Behavioral Vulnerability as a Trigger for PrEP Resumption Among Adolescent Girls and Young Women in East and Southern Africa.

IF 3.7 2区医学 Q2 INFECTIOUS DISEASES Current HIV/AIDS Reports Pub Date : 2023-12-01 Epub Date: 2023-12-05 DOI:10.1007/s11904-023-00680-y

Krishnaveni Reddy, Thesla Palanee-Phillips, Renee Heffron

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Abstract

Purpose of review: East and Southern Africa are the epicenter of the HIV epidemic. High HIV incidence rates among adolescent girls and young women (AGYW) remain stable over the last decade despite access to daily oral PrEP. Some settings have experienced high PrEP uptake among AGYW; however, discontinuation has been high. This review sought to understand drivers of PrEP discontinuation in this population in order to identify potential mechanisms to facilitate PrEP restart and optimize PrEP use.

Recent findings: Drivers of PrEP discontinuation included low perceived HIV acquisition risk, PrEP-associated side effects, pill burden, family/sexual partner disapproval, lack of/intermittent sexual activity, PrEP use stigma, fear of intimate partner violence, misinformation about long-term PrEP use, and limited/inconsistent access to PrEP. The most frequently reported driver of PrEP discontinuation was low perceived HIV acquisition risk. This indicates that innovative interventions to help AGYW recognize their HIV risk and make informed decisions about PrEP use are urgently needed.

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东部和南部非洲的少女和年轻女性对性和行为脆弱性加剧的认识是恢复 PrEP 的触发因素。

审查目的：东部和南部非洲是艾滋病毒疫情的中心。在过去十年中，少女和年轻女性（AGYW）的艾滋病高发病率保持稳定，尽管她们可以获得每日口服的 PrEP。在一些地区，少女和年轻女性对 PrEP 的接受率很高，但中断治疗的比例也很高。本综述旨在了解导致该人群中断 PrEP 的原因，从而确定促进 PrEP 重启和优化 PrEP 使用的潜在机制：终止使用 PrEP 的驱动因素包括：感知到的 HIV 感染风险低、与 PrEP 相关的副作用、服药负担、家庭/性伴侣不认可、缺乏/间断性活动、对使用 PrEP 的污名化、害怕亲密伴侣暴力、关于长期使用 PrEP 的错误信息，以及获得 PrEP 的途径有限/不一致。最常报告的导致停止使用 PrEP 的原因是认为感染艾滋病毒的风险较低。这表明，亟需采取创新性干预措施，帮助 AGYW 认识到其感染艾滋病毒的风险，并就 PrEP 的使用做出明智的决定。

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来源期刊

Current HIV/AIDS Reports INFECTIOUS DISEASES-

CiteScore

8.10

自引率

2.20%

发文量

期刊介绍： This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of HIV/AIDS. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antiretroviral therapies, behavioral aspects of management, and metabolic complications and comorbidity. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.