{"title":"PrEP Uptake and Utilisation Among Adolescent Girls and Young Women in Sub-Saharan Africa: A Scoping Review.","authors":"Jenny Chen-Charles, Dvora Joseph Davey, Elona Toska, Janet Seeley, Linda-Gail Bekker","doi":"10.1007/s10461-025-04656-4","DOIUrl":null,"url":null,"abstract":"<p><p>Adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) are disproportionately affected by HIV. Despite the effectiveness of oral pre-exposure prophylaxis (PrEP) in preventing HIV, uptake and effective utilisation among AGYW remain suboptimal. This scoping review maps research on PrEP delivery outside clinical trials to AGYW in SSA. Quantitative and qualitative data were extracted from 58 studies on the facilitators and barriers to PrEP uptake and utilisation (including initiation, persistence, and adherence), and recommendations for effective PrEP delivery from AGYW and PrEP providers. Only studies on oral PrEP met the inclusion criteria. Facilitators of effective PrEP utilisation included social support with strong familial and peer networks positively influencing PrEP adherence and persistence. Healthcare provider interactions were pivotal in promoting PrEP uptake through dissemination of accurate information and ongoing support. Studies reported consistent barriers to PrEP uptake and utilisation including anticipated or experienced stigma, pill burden, and side effects. Addressing identified barriers and leveraging facilitators can enhance future effectiveness for PrEP delivery. There is a lack of strategies to support AGYW in long-term persistence and engagement with PrEP services. Our findings emphasise the urgent need for people-centred and localised, context-specific strategies to improve PrEP delivery among AGYW in SSA. Effective PrEP delivery strategies should include differentiated service delivery models, innovative approaches such as digital health, and integration with existing services such as antenatal care for pregnant and breastfeeding AGYW. More data is needed for PrEP delivery among AGYW across the region, including other PrEP modalities as they roll out.</p>","PeriodicalId":7543,"journal":{"name":"AIDS and Behavior","volume":" ","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"AIDS and Behavior","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10461-025-04656-4","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
PrEP Uptake and Utilisation Among Adolescent Girls and Young Women in Sub-Saharan Africa: A Scoping Review.
Adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) are disproportionately affected by HIV. Despite the effectiveness of oral pre-exposure prophylaxis (PrEP) in preventing HIV, uptake and effective utilisation among AGYW remain suboptimal. This scoping review maps research on PrEP delivery outside clinical trials to AGYW in SSA. Quantitative and qualitative data were extracted from 58 studies on the facilitators and barriers to PrEP uptake and utilisation (including initiation, persistence, and adherence), and recommendations for effective PrEP delivery from AGYW and PrEP providers. Only studies on oral PrEP met the inclusion criteria. Facilitators of effective PrEP utilisation included social support with strong familial and peer networks positively influencing PrEP adherence and persistence. Healthcare provider interactions were pivotal in promoting PrEP uptake through dissemination of accurate information and ongoing support. Studies reported consistent barriers to PrEP uptake and utilisation including anticipated or experienced stigma, pill burden, and side effects. Addressing identified barriers and leveraging facilitators can enhance future effectiveness for PrEP delivery. There is a lack of strategies to support AGYW in long-term persistence and engagement with PrEP services. Our findings emphasise the urgent need for people-centred and localised, context-specific strategies to improve PrEP delivery among AGYW in SSA. Effective PrEP delivery strategies should include differentiated service delivery models, innovative approaches such as digital health, and integration with existing services such as antenatal care for pregnant and breastfeeding AGYW. More data is needed for PrEP delivery among AGYW across the region, including other PrEP modalities as they roll out.
期刊介绍:
AIDS and Behavior provides an international venue for the scientific exchange of research and scholarly work on the contributing factors, prevention, consequences, social impact, and response to HIV/AIDS. This bimonthly journal publishes original peer-reviewed papers that address all areas of AIDS behavioral research including: individual, contextual, social, economic and geographic factors that facilitate HIV transmission; interventions aimed to reduce HIV transmission risks at all levels and in all contexts; mental health aspects of HIV/AIDS; medical and behavioral consequences of HIV infection - including health-related quality of life, coping, treatment and treatment adherence; and the impact of HIV infection on adults children, families, communities and societies. The journal publishes original research articles, brief research reports, and critical literature reviews. provides an international venue for the scientific exchange of research and scholarly work on the contributing factors, prevention, consequences, social impact, and response to HIV/AIDS. This bimonthly journal publishes original peer-reviewed papers that address all areas of AIDS behavioral research including: individual, contextual, social, economic and geographic factors that facilitate HIV transmission; interventions aimed to reduce HIV transmission risks at all levels and in all contexts; mental health aspects of HIV/AIDS; medical and behavioral consequences of HIV infection - including health-related quality of life, coping, treatment and treatment adherence; and the impact of HIV infection on adults children, families, communities and societies. The journal publishes original research articles, brief research reports, and critical literature reviews.5 Year Impact Factor: 2.965 (2008) Section ''SOCIAL SCIENCES, BIOMEDICAL'': Rank 5 of 29 Section ''PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH'': Rank 9 of 76