The influence of HIV-related stigma on PrEP disclosure and adherence among adolescent girls and young women in HPTN 082: a qualitative study.

Journal of the International AIDS Society
Jennifer VellozaHPTN 082 study group

Abstract

Stigma and disclosure concerns have been key barriers to oral pre-exposure prophylaxis (PrEP) adherence for African adolescent girls and young women (AGYW) in efficacy trials. We aimed to understand the impact of these factors among African AGYW in an open-label PrEP study. HPTN 082 was an open-label PrEP study among AGYW (ages 16 to 24) in Harare, Zimbabwe, and Cape Town and Johannesburg, South Africa from 2016 to 2018. Women starting PrEP were randomized to standard adherence support (counselling, two-way SMS, monthly adherence clubs) or standard support plus drug-level feedback. Serial in-depth interviews were conducted among 67 AGYW after 13-week and 26-week study visits to explore experiences of stigma, disclosure and PrEP adherence. We analysed data by coding transcripts and memo-writing and diagramming to summarize themes. AGYW described stigma related to sexual activity (e.g. "people say I'm a prostitute") and being perceived to be living with HIV because of taking antiretrovirals (e.g. "my husband's friends say I'm HIV infected"). Participants who anticipated stigma were reluctant to disclose PrEP use and reported adherence challenges. Disclosure also resulted in stigmatizing experiences. Across all sites, negative des...Continue Reading

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Citations

Jun 12, 2020·Journal of the International AIDS Society·Ariane van der StratenUNKNOWN MTN-041/MAMMA Study Team
Nov 29, 2020·Journal of the International AIDS Society·Connie L CelumLinda-Gail Bekker
Jan 4, 2021·AIDS and Behavior·Marie C D StonerAriane van der Straten
Apr 7, 2021·AIDS Education and Prevention : Official Publication of the International Society for AIDS Education·Miriam HartmannSarah T Roberts
Jan 26, 2021·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Fernandos K OngollyGabrielle O'Malley
May 12, 2021·Journal of the International AIDS Society·Renee HeffronNelly Mugo
Jul 17, 2021·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Seth C KalichmanLisa A Eaton

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NCT02732730

Software Mentioned

NVivo

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