"These Girls Have a Chance to be the Future Generation of HIV Negative": Experiences of Implementing a PrEP Programme for Adolescent Girls and Young Women in South Africa.
"These Girls Have a Chance to be the Future Generation of HIV Negative": Experiences of Implementing a PrEP Programme for Adolescent Girls and Young Women in South Africa.
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DOI：
10.1007/s10461-022-03750-1
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发表时间：
2023-01
影响因子：
4.4
通讯作者：
Mathews, Catherine
中科院分区：
文献类型：
--
作者：
Duby, Zoe;Bunce, Brittany;Fowler, Chantal;Jonas, Kim;Bergh, Kate;Govindasamy, Darshini;Wagner, Colleen;Mathews, Catherine
每日口服暴露前预防（PrEP）对预防艾滋病毒非常有效。在南非，青春期女孩和年轻妇女（AGYW）被优先考虑为PrEP提供。2019-2022年，在南非12个艾滋病毒流行率高的地区实施了一项艾滋病毒预防综合干预措施，为15-24岁的AGYW提供综合的生物医学，行为和结构干预措施。我们进行了定性访谈，探讨PrEP实施经验与38个人参与实施艾滋病毒预防综合方案，包括方案经理和项目协调员，卫生保健提供者/护士，社会工作者，辅导员，同伴小组培训师和外展工作者。叙述包括与实施者经历的PrEP吸收，依从性和可接受性相关的各种挑战。PrEP可接受性的障碍包括AGYW对副作用的恐惧和对注射而不是每日口服PrEP的偏好;由于缺乏准确的信息，AGYW，社区和父母对PrEP的抵制;与抗逆转录病毒药物和滥交假设相关的PrEP耻辱;以及与父母同意有关的问题。此外，实施者面临的后勤挑战与采购，缺货，和供应的PrEP. Findings强调成功实施的父母和社区的可接受性的PrEP的关键作用。总体而言，PrEP被执行者视为一种宝贵的艾滋病毒预防工具。为了确保南非AGYW获得PrEP，需要努力减少耻辱和促进对PrEP使用的社会支持，开展提高认识的运动，确保PrEP的积极框架，并建立社区对PrEP的可接受性。
Daily oral pre-exposure prophylaxis (PrEP) is highly efficacious for HIV prevention. Adolescent girls and young women (AGYW) have been prioritised for PrEP delivery in South Africa. A combination HIV prevention intervention providing integrated biomedical, behavioural and structural interventions for AGYW aged 15–24 in twelve districts in South Africa characterised by high HIV prevalence, was implemented 2019–2022. We conducted qualitative interviews to explore PrEP implementation experiences with 38 individuals involved in the implementation of the combination HIV prevention programme, including programme managers and project coordinators, health care providers / nurses, social workers, counsellors, peer group trainers and outreach workers. Narratives included various challenges associated with PrEP uptake, adherence and acceptability experienced by implementers. Barriers to PrEP acceptability included AGYW fears of side effects and preference for injectable versus daily oral PrEP; resistance towards PrEP from AGYW, communities and parents due to a lack of accurate information; PrEP stigma linked to associations with antiretrovirals and assumptions of promiscuity; and issues pertaining to parental consent. Additionally, implementers faced logistical challenges related to procurement, stockouts, and supply of PrEP. Findings highlighted the critical role of parental and community acceptability of PrEP for successful implementation. Overall, PrEP was perceived by implementers as a valuable HIV prevention tool. In order to ensure the accessibility of PrEP for AGYW in South Africa, efforts to reduce stigma and foster social support for PrEP use, campaigns to raise awareness, ensure positive framing of PrEP, and build community acceptability of PrEP, are needed.
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影响因子：
4.5
作者：
Jackson-Gibson M;Ezema AU;Orero W;Were I;Ohiomoba RO;Mbullo PO;Hirschhorn LR
通讯作者：
Hirschhorn LR
影响因子：
16.1
作者：
Amico, K. Rivet;Bekker, Linda-Gail
通讯作者：
Bekker, Linda-Gail
影响因子：
4.9
作者：
Kuo, Caroline;Dietrich, Janan;Mathews, Catherine
通讯作者：
Mathews, Catherine
影响因子：
6
作者：
Celum CL;Gill K;Morton JF;Stein G;Myers L;Thomas KK;McConnell M;van der Straten A;Baeten JM;Duyver M;Mendel E;Naidoo K;Dallimore J;Wiesner L;Bekker LG
通讯作者：
Bekker LG
影响因子：
2.6
作者：
Bellows, Laura L.;McCloskey, Morgan;Johnson, Susan L.
通讯作者：
Johnson, Susan L.