"I know why I am taking this pill": Young women navigation of disclosure and support for PrEP uptake and adherence in Eastern Cape Province, South Africa.
"I know why I am taking this pill": Young women navigation of disclosure and support for PrEP uptake and adherence in Eastern Cape Province, South Africa.
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DOI：
10.1371/journal.pgph.0000636
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发表时间：
2023
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对少女和年轻妇女（AGYW）的披露与使用口服暴露前预防（PrEP）和依从性的社会支持之间的动态相互作用的了解有限。为此，我们对42名参加社区PrEP研究的AGYW进行了访谈，这些AGYW在干血斑中表现出高或低的替诺福韦二磷酸（ttfv - dp）血浓度。在实践理论的指导下，访谈和分析侧重于AGYW在PrEP披露、支持和坚持方面的观点和经验。高ttv - dp血浓度的AGYW描述了更大的社会支持网络和披露事件。相比之下，那些血液中ttv - dp浓度低的人向更少的人透露，导致有限的社会支持。参与者讨论了伴侣支持，然而，无论tvv - dp水平如何，这种支持并未被描述为依从性的结果。血液中tv - dp水平高的人能够应对社会审查和社会支持的变化，而血液中tv - dp水平低的人更有可能质疑自己是否继续使用PrEP。为了促进AGYW预防有效地使用PrEP，应将扩大披露和应对社会支持变化的技能建设作为PrEP服务的一部分进行检查。
There is limited understanding of the dynamic interplay between adolescent girl’s and young women’s (AGYW) disclosure and social support for using oral pre-exposure prophylaxis (PrEP) and adherence. Towards this, we conducted interviews with 42 AGYW enrolled in The Community PrEP Study who exhibited either high or low blood concentrations of tenofovir-diphosphate (TFV-DP) in dried blood spots. Guided by Theories of Practice, interviews and analysis focused on AGYW perspectives and experiences with PrEP disclosure, support and adherence. AGYW with high TFV-DP blood concentrations described larger social support networks and disclosure events. In contrast, those with low TFV-DP blood concentrations described disclosing to fewer people, resulting in limited social support. Participants discussed partner support, however, this support was not described as consequential to adherence, irrespective of TFV-DP levels. Those with high levels of TFV-DP in their blood described the ability to navigate social scrutiny and changes in social support, while those with low levels of TFV-DP in their blood were more likely to question their own continued use of PrEP. To facilitate AGYW’s prevention-effective use of PrEP, expanded skill-building for disclosure and resiliency against changes to social support should be examined as part of PrEP services.