Picture me HIV Free: Using Photovoice to Identify Factors Shaping PrEP Adherence

项目摘要 撒哈拉以南非洲的少女和年轻妇女（AGYW）受到艾滋病毒的严重影响。 疫情暴露前预防（PrEP），如果每天使用，可以减少新的艾滋病毒感染的人数， AGYW。然而，影响AGYW中PrEP依从性和持久性的多层次因素是 替补演员拟议的研究-图片我艾滋病毒免费：使用Photovoice识别因素塑造 PrEP坚持-将使用Photovoice，一种建立在社区基础上的参与性研究方法， 确定影响AGYW之间坚持和坚持PrEP的突出多层次因素。我们将 与PEPFAR赞助的DREAMS计划合作，为AGYW提供PrEP， 肯尼亚，基苏穆。参与拟议研究的人员将拍摄照片并编写说明，以描述 照片中图像的背景。使用这种方法，参与者记录，反思和讨论 围绕艾滋病毒预防的个人和共同现实在他们的社区和形状中非常突出 他们的日常生活在目标1中，我们将识别和描述影响PrEP依从性的多层次因素 在AGYW中，通过使用Photovoice与参加DREAMS的AGYW，他们已经启动了PrEP，AGYW 没有启动PrEP的人（同伴），男性伴侣和男性同伴，家庭成员和社区 成员，包括医疗保健提供者。参与者将参与群组内讨论（其中单个 研究人群，例如，AGYW谁发起了PrEP，见面分享和讨论他们的照片， 观点）和群组间讨论（其中两个研究群体，例如，AGYW和社区 成员，分享和讨论他们的照片和观点）。与AGYW的深入访谈， 启动的PrEP将遵循，以确定如何更广泛的水平因素，共同确定在 Photovoice讨论影响个人行为。使用类似的过程，我们将从事相同的 目标2中的人群组，以识别和描述影响PrEP持续性的多水平因素， 包括“危险季节”。通过识别和描述AGYW多个层面的因素， 社会生态影响PrEP坚持和AGYW之间的持久性，我们将有能力识别 并将未来干预措施的组成部分放在对支持遵守最重要的领域， 坚持在AGYW中进行PrEP。然后，我们将制定和评估干预措施，作为未来的一部分， research.

PROJECT SUMMARY Adolescent girls and young women (AGYW) in sub-Saharan Africa are disproportionally affected by the HIV epidemic. Pre-exposure prophylaxis (PrEP), if used daily, can reduce the number of new HIV infections among AGYW. The multi-level factors that influence PrEP adherence and persistence among AGYW, however, are understudied. The proposed research—Picture Me HIV Free: Using Photovoice to Identify Factors Shaping PrEP Adherence—will use Photovoice, an established community-based participatory research method, to identify salient multi-level factors that influence adherence and persistence to PrEP among AGYW. We will partner with a PEPFAR-sponsored DREAMS Initiative program that provides AGYW access to PrEP in Kisumu, Kenya. Participants in the proposed research will take photographs and write captions to describe the context of the images in the photographs. Using this approach, participants record, reflect, and discuss the personal and shared realities surrounding HIV prevention that are salient within their communities and shape their day-to-day lives. In Aim 1, we will identify and describe multi-level factors that affect adherence to PrEP among AGYW through using Photovoice with AGYW enrolled in DREAMS who have initiated PrEP, AGYW who have not initiated PrEP (peers), male partners and male peers, family members, and community members, including healthcare providers. Participants will engage in intra-cohort discussions (where a single study population, e.g., AGYW who have initiated PrEP, meet to share and discuss their photographs and perspectives) and inter-cohort discussions (where two study populations, e.g., AGYW and community members, share and discuss their photographs and perspectives). In-depth interviews with AGYW who have initiated PrEP will follow to determine how the broader level factors that were collectively identified during the Photovoice discussions influence individual behavior. Using a similar process, we will engage the same population groups in Aim 2 to identify and describe the multi-level factors that affect persistence to PrEP, including “seasons of risk”, among AGYW. By identifying and describing factors from multiple levels of AGYW’s social ecology that influence PrEP adherence and persistence among AGYW, we will be equipped to identify and position components of future interventions in areas that matter most in supporting adherence and persistence to PrEP among AGYW. We will then develop and evaluate the intervention as part of future research.