HIV PrEP Perspectives of Liberian Adolescent Girls and Young Women and their Providers

项目摘要/摘要 暴露前预防(PrEP)在撒哈拉以南非洲(SSA)越来越多地可用，并作为一种 高效和用户控制的艾滋病毒预防干预措施为那些最有可能感染艾滋病毒的人带来了希望 感染，包括青春期女孩和年轻妇女(AGYW)。然而，PrEP的大部分摄取增加 在SSA已经在少数几个艾滋病毒感染率最高的国家，在那里艾滋病毒流行率可以 影响风险认知和使用PrEP的意愿。尽管这些地区和其他地区的PrEP有所上升，但 大多数有资格获得PrEP的人都没有使用它，而在那些开始使用PrEP的人中，停止使用 启动后几个月的费率很常见，特别是对AGYW来说， 在西非，艾滋病毒感染率较低，但高得令人无法接受，PrEP正开始推广。公众 利比里亚卫生当局已采取措施，将预防艾滋病方案纳入该国的艾滋病毒预防方案。 最近开始了试点诊所，为与男性发生性关系的男性、变性人女性， 以及注射毒品的人。在2023-24年，PrEP将在全国范围内扩大到包括最大的关键人群 AGYW。这些政策制定者对开发对偏好敏感的PrEP方案非常感兴趣 并反映了在西非背景下非洲青年团参与PrEP的决定因素，这有别于 非洲其他地区的数据。因此，我们建议对PrEP有更深入的了解 利比里亚城市和农村AGYW、他们的男性伴侣和医疗保健的看法和偏好 提供商-应用情景信息、动机和行为技能(SIMB)模型来指导我们的 调查。在与PrEP规划者的密切合作下，我们将使用干预映射框架 将形成的数据直接应用于为AGYW制定PrEP实施规划的进程。 由此产生的实施备选方案将成为下一阶段在利比里亚推出关键的PrEP的路线图 并作为类似设置的典范。

PROJECT SUMMARY/ABSTRACT Pre-Exposure Prophylaxis (PrEP) is becoming increasingly available in sub-Saharan Africa (SSA) and as a highly effective and user-controlled intervention for HIV prevention holds promise for those most at risk of infection including adolescent girls and young women (AGYW). However, most of the increased uptake of PrEP in SSA has been in a handful of countries with the world’s highest HIV rates, and where the HIV prevalence can influence risk perception and willingness to use PrEP. Despite the rise PrEP in these and other regions where it is available, most of those eligible for PrEP are not using it, and among those that do begin PrEP, discontinuation rates in the months after initiation is common, especially for AGYW, In West Africa, where HIV rates are lower but unacceptably high, PrEP is beginning to be rolled out. Public health authorities in Liberia have taken steps to integrate PrEP into the country’s HIV prevention programming and have recently started pilot clinics to administer PrEP to men who have sex with men, transgender women, and people who inject drugs. In 2023-24, PrEP will be expanded nationwide to include the largest key population AGYW. These policymakers are deeply interested in developing PrEP programming that is preference-sensitive and reflects determinants of PrEP engagement for AGYW in the West African context, which is distinct from those of other regions of Africa. Therefore, we propose to obtain an in-depth understanding of the PrEP perceptions and preferences among urban and rural AGYW in Liberia, their male partners, and healthcare providers – applying the situated Information, Motivation, and Behavioral Skills (sIMB) model to guide our investigations. In close collaboration with PrEP planners, we will then use Intervention Mapping framework processes to directly apply the formative data to the development of implementation planning for PrEP for AGYW. The resulting implementation options will serve as a roadmap for the critical next stage of PrEP roll-out in Liberia and serve as a model for similar settings.