Factors that influence adolescent girls and young women's re-initiation or complete discontinuation from daily oral PrEP use: a qualitative study from Eastern Cape Province, South Africa.
Factors that influence adolescent girls and young women's re-initiation or complete discontinuation from daily oral PrEP use: a qualitative study from Eastern Cape Province, South Africa.
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DOI：
10.1002/jia2.26175
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发表时间：
2023-09
影响因子：
6
通讯作者：
Medina-Marino, Andrew
中科院分区：
文献类型：
--
作者：
de Vos, Lindsey;Mudzingwa, Emily Krogstad;Fynn, Lauren;Atujuna, Millicent;Mugore, Matinatsa;Gandhi, Monica;Celum, Connie;Hosek, Sybil;Bekker, Linda-Gail;Daniels, Joseph;Medina-Marino, Andrew
关键词：
青少年女孩和年轻女性（AGYW）面临着危及其预防的障碍-有效使用每日口服暴露前预防（PrEP）。我们试图了解影响AGYW长期中断PrEP使用的因素，以及他们在基于社区的依从性支持干预的背景下重新启动或停止使用PrEP的决定。在2019年12月至2021年4月期间，对有意选择的AGYW（16-25岁）进行了深入访谈（IDI），这些AGYW参加了南非东开普省布法罗城地铁卫生区的社区PrEP研究（CPS）。AGYW在两个社区研究中心每月提供PrEP，为期24个月。访谈指南由信息-动机-行为技能模型提供信息，并使用说明性代码报告和案例分析对数据进行分析。在母研究中，共招募了603名参与者并开始接受PrEP治疗。对50名CPS参与者进行了53次IDI。研究结果显示，外部因素（例如当地运动，学校假期和药物副作用）和社会冲突（例如自由裁量权和合作伙伴的不信任）直接影响PrEP使用的中断。一个人对艾滋病毒风险的自我认知的降低延长了这些“PrEP休息”的持续时间。一旦错过了PrEP补充访视，一些AGYW由于害怕被研究人员责骂而推迟返回补充。最终重新启动PrEP的参与者与脱离PrEP使用的参与者之间的差异可归因于社会支持和鼓励，对PrEP的熟悉程度，风险认知，与工作人员的自我发起讨论以及副作用的减少。尽管实施了基于社区的PrEP提供平台和行为干预，包括支持每日口服PrEP依从性和披露，但参与者仍在努力坚持每日口服PrEP使用。不可预测的生活事件，包括当地的运动和上学时间表，除了根据他们的感知行为进行判断外，还对AGYW和习惯形成的一致药丸拾取提出了挑战。长效可注射PrEP可能会减轻这些外部障碍。整合长期规划技能的干预措施，如何驾驭现有的社会判断以及如何获得社会支持的来源，可能会进一步改善PrEP使用的习惯形成，无论其制定如何。
Adolescent girls and young women (AGYW) face barriers that jeopardize their prevention‐effective use of daily oral pre‐exposure prophylaxis (PrEP). We sought to understand factors that influence AGYW's prolonged breaks in PrEP use, and their decisions to re‐initiate or discontinue using PrEP in the context of a community‐based adherence support intervention. In‐depth interviews (IDIs) were conducted between December 2019 and April 2021 with purposively selected AGYW (aged 16–25) enrolled in the Community PrEP Study (CPS) in Buffalo City Metro Health District, Eastern Cape Province, South Africa. AGYW were offered monthly PrEP for 24 months at two community‐based study sites. Interview guides were informed by the Information‐Motivation‐Behavioural Skills Model, and data were analysed using illustrative code reports and a case analysis. A total of 603 participants were enrolled and initiated on PrEP in the parent study. Fifty‐three IDIs were conducted with 50 CPS participants. Findings revealed that external factors (e.g. local movement, school holidays and medication side‐effects) and social conflicts (e.g. discretion and partner mistrust) directly influenced breaks in PrEP usage. A decrease in one's self‐perception of HIV risk prolonged the duration of these “PrEP breaks.” Once PrEP refill visits were missed, some AGYW delayed returning for refills out of fear of being scolded by study staff. The differences between those participants who eventually re‐initiated PrEP and those who disengaged from PrEP use can be attributed to social support and encouragement, level of familiarity with PrEP, risk perceptions, self‐initiated discussions with staff and diminishing side effects. Despite implementing a community‐based PrEP delivery platform and behavioural intervention that included support for daily oral PrEP adherence and disclosure, participants struggled with consistent daily oral PrEP use. Unpredictable life events, including local movement and schooling schedules, in addition to being judged for their perceived behaviours, pose a challenge for consistent pill pick‐up for AGYW and habit formation. Long‐acting injectable PrEP may mitigate a number of these external barriers. Interventions that integrate long‐term planning skills, how to navigate existing social judgements and how to access sources of social support may further improve habit formation for PrEP use, regardless of its formulation.
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影响因子：
4.5
作者：
Bjertrup PJ;Mmema N;Dlamini V;Ciglenecki I;Mpala Q;Matse S;Kerschberger B;Wringe A
通讯作者：
Wringe A
影响因子：
4.4
作者：
Duby, Zoe;Bunce, Brittany;Fowler, Chantal;Jonas, Kim;Bergh, Kate;Govindasamy, Darshini;Wagner, Colleen;Mathews, Catherine
通讯作者：
Mathews, Catherine
影响因子：
3.7
作者：
Lunkuse, Jane Frances;Kamacooko, Onesmus;Muturi-Kioi, Vincent;Chinyenze, Kundai;Kuteesa, Monica O.;Price, Matt A.;Mayanja, Yunia
通讯作者：
Mayanja, Yunia
影响因子：
2.2
作者：
Barnighausen, Kate;Geldsetzer, Pascal;McMahon, Shannon A.
通讯作者：
McMahon, Shannon A.
影响因子：
6
作者：
Celum, Connie L.;Delany-Moretlwe, Sinead;Bekker, Linda-Gail
通讯作者：
Bekker, Linda-Gail