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The effect of PrEP use disclosure on adherence in a cohort of adolescent girls and young women in South Africa
Giovenco, D., Pettifor, A., Powers, K. A., Hightow-Weidman, L., Pence, B. W., Edwards, J. K., Gill, K., Morton, J. F., van der Straten, A., Celum, C., & Bekker, L.-G. (2022). The effect of PrEP use disclosure on adherence in a cohort of adolescent girls and young women in South Africa. AIDS and Behavior, 26(4), 1007-1016. https://doi.org/10.1007/s10461-021-03455-x
Effective strategies to support PrEP adherence among adolescent girls and young women (AGYW) are needed. We examined PrEP use disclosure and its effect on adherence among 200 AGYW ages 16-25 initiating PrEP in South Africa to help inform these strategies. We estimated the relative prevalence of high adherence (intracellular tenofovir-diphosphate concentration ≥ 700 fmol/punch) 3- and 6-months after PrEP initiation among those who disclosed vs. did not disclose their PrEP use, both overall and by age. Most AGYW disclosed to a parent (58%), partner (58%), or friend (81%) by month 6. We did not observe a strong effect of disclosure on adherence overall; however, among younger AGYW (≤ 18 years), those who disclosed to a parent were 6.8 times as likely to have high adherence at month 6 than those who did not (95% CI 1.02, 45.56). More work is needed to understand parents' roles as allies and identify ways peers and partners can motivate PrEP use for AGYW.