Preferences for oral PrEP dosing among adolescent boys and young men in three sub-Saharan African countries
HIV remains a leading contributor to the disease burden in sub-Saharan Africa, with adolescents and young people disproportionately affected. Optimising pre-exposure prophylaxis (PrEP) uptake has predominantly focused on women and adult men who have sex with men. We explore adolescent boys and young...
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| Veröffentlicht in: | PloS one 2023-10, Vol.18 (10), p.e0285132-e0285132 |
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| creator | Kakande, Ayoub Ssemata, Andrew Sentoogo Muhumuza, Richard Atujuna, Millicent Abaasa, Andrew Ndekezi, Denis Tshabalala, Gugulethu Nematadzira, Teacler Hornschuh, Stefanie Nomvuyo, Mangxilana Ahmed, Nadia Maluadzi, Mamakiri Anne Weiss, Helen Webb, Emily Stranix-Chibanda, Lynda Janine Dietrich, Janan Seeley, Janet Fox, Julie |
| description | HIV remains a leading contributor to the disease burden in sub-Saharan Africa, with adolescents and young people disproportionately affected. Optimising pre-exposure prophylaxis (PrEP) uptake has predominantly focused on women and adult men who have sex with men. We explore adolescent boys and young men's PrEP uptake preferences in South Africa, Uganda, and Zimbabwe.
A cross-sectional sequential exploratory mixed-methods study amongst males aged 13-24 years was conducted between April and September 2019 as part of the CHAPS trial. Group discussions (GDs) and In-Depth Interviews (IDIs) focused on motivations and hindrances for HIV testing, PrEP preference, and reasons for the uptake of PrEP. A thematic approach was used to analyse the qualitative data. A quantitative survey following the qualitative work covered questions on demographics, HIV risk and PrEP preferences (on-demand vs. daily). For quantitative analysis, we fitted logistic regression models to determine factors associated with on-demand vs daily PrEP preference.
Overall, 647 adolescent boys and young men (median age 20, IQR: 17-22) were enrolled. Of these, 422 (65.22%) preferred on-demand PrEP (South Africa 45.45%, Uganda 76.80%, Zimbabwe 70.35%; p24 hours in advance aOR = 1.4 (0.9-2.3) compared to |
| doi_str_mv | 10.1371/journal.pone.0285132 |
| format | Article |
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A cross-sectional sequential exploratory mixed-methods study amongst males aged 13-24 years was conducted between April and September 2019 as part of the CHAPS trial. Group discussions (GDs) and In-Depth Interviews (IDIs) focused on motivations and hindrances for HIV testing, PrEP preference, and reasons for the uptake of PrEP. A thematic approach was used to analyse the qualitative data. A quantitative survey following the qualitative work covered questions on demographics, HIV risk and PrEP preferences (on-demand vs. daily). For quantitative analysis, we fitted logistic regression models to determine factors associated with on-demand vs daily PrEP preference.
Overall, 647 adolescent boys and young men (median age 20, IQR: 17-22) were enrolled. Of these, 422 (65.22%) preferred on-demand PrEP (South Africa 45.45%, Uganda 76.80%, Zimbabwe 70.35%; p<0.001). Factors independently associated with on-demand PrEP included country (South Africa, adjusted odds ratio (aOR) = 0.19 [95%CI:0.1-0.3] compared to Uganda) and advanced planning of sex [>24 hours in advance aOR = 1.4 (0.9-2.3) compared to <2 hours]. Qualitatively, participants commonly believed they were not at risk of HIV acquisition most of the time and thought that on-demand PrEP would be suitable as they tend to plan sexual activity in advance.
Preference for on-demand PrEP is high in young males. The qualitative data support a preference for on-demand PrEP in those who plan sex in advance. HIV intervention programs should offer both on-demand and daily PrEP to engage more adolescent boys and young men in HIV prevention practices.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0285132</identifier><identifier>PMID: 37812644</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adolescents ; Adult ; Analysis ; Anti-HIV Agents - therapeutic use ; Biology and Life Sciences ; Boys ; Councils ; Cross-Sectional Studies ; Data collection ; Demographics ; Disease prevention ; Female ; Health aspects ; Health risks ; HIV ; HIV (Viruses) ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV Infections - prevention & control ; HIV testing ; Homosexuality, Male ; Human immunodeficiency virus ; Humans ; Male ; Medical tests ; Medicine and Health Sciences ; Men ; People and Places ; Pre-Exposure Prophylaxis - methods ; Preferences ; Prevention ; Prophylaxis ; Qualitative analysis ; Quantitative analysis ; Regression analysis ; Regression models ; Research ethics ; Sex ; Sexual and Gender Minorities ; Sexually transmitted diseases ; Social sciences ; South Africa ; STD ; Teenagers ; Variables ; Young Adult ; Young adults ; Youth</subject><ispartof>PloS one, 2023-10, Vol.18 (10), p.e0285132-e0285132</ispartof><rights>Copyright: © 2023 Kakande et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 Kakande et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Kakande et al 2023 Kakande et al</rights><rights>2023 Kakande et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c693t-f2e7617f63626f81981e953b93fdda82be9f4fea23162c3a2a63d7c8faacd75c3</citedby><cites>FETCH-LOGICAL-c693t-f2e7617f63626f81981e953b93fdda82be9f4fea23162c3a2a63d7c8faacd75c3</cites><orcidid>0000-0003-1287-2634 ; 0000-0003-3566-1688 ; 0000-0002-0243-5601</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10561834/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10561834/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37812644$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Matovu, Joseph K. B.</contributor><creatorcontrib>Kakande, Ayoub</creatorcontrib><creatorcontrib>Ssemata, Andrew Sentoogo</creatorcontrib><creatorcontrib>Muhumuza, Richard</creatorcontrib><creatorcontrib>Atujuna, Millicent</creatorcontrib><creatorcontrib>Abaasa, Andrew</creatorcontrib><creatorcontrib>Ndekezi, Denis</creatorcontrib><creatorcontrib>Tshabalala, Gugulethu</creatorcontrib><creatorcontrib>Nematadzira, Teacler</creatorcontrib><creatorcontrib>Hornschuh, Stefanie</creatorcontrib><creatorcontrib>Nomvuyo, Mangxilana</creatorcontrib><creatorcontrib>Ahmed, Nadia</creatorcontrib><creatorcontrib>Maluadzi, Mamakiri</creatorcontrib><creatorcontrib>Anne Weiss, Helen</creatorcontrib><creatorcontrib>Webb, Emily</creatorcontrib><creatorcontrib>Stranix-Chibanda, Lynda</creatorcontrib><creatorcontrib>Janine Dietrich, Janan</creatorcontrib><creatorcontrib>Seeley, Janet</creatorcontrib><creatorcontrib>Fox, Julie</creatorcontrib><title>Preferences for oral PrEP dosing among adolescent boys and young men in three sub-Saharan African countries</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>HIV remains a leading contributor to the disease burden in sub-Saharan Africa, with adolescents and young people disproportionately affected. Optimising pre-exposure prophylaxis (PrEP) uptake has predominantly focused on women and adult men who have sex with men. We explore adolescent boys and young men's PrEP uptake preferences in South Africa, Uganda, and Zimbabwe.
A cross-sectional sequential exploratory mixed-methods study amongst males aged 13-24 years was conducted between April and September 2019 as part of the CHAPS trial. Group discussions (GDs) and In-Depth Interviews (IDIs) focused on motivations and hindrances for HIV testing, PrEP preference, and reasons for the uptake of PrEP. A thematic approach was used to analyse the qualitative data. A quantitative survey following the qualitative work covered questions on demographics, HIV risk and PrEP preferences (on-demand vs. daily). For quantitative analysis, we fitted logistic regression models to determine factors associated with on-demand vs daily PrEP preference.
Overall, 647 adolescent boys and young men (median age 20, IQR: 17-22) were enrolled. Of these, 422 (65.22%) preferred on-demand PrEP (South Africa 45.45%, Uganda 76.80%, Zimbabwe 70.35%; p<0.001). Factors independently associated with on-demand PrEP included country (South Africa, adjusted odds ratio (aOR) = 0.19 [95%CI:0.1-0.3] compared to Uganda) and advanced planning of sex [>24 hours in advance aOR = 1.4 (0.9-2.3) compared to <2 hours]. Qualitatively, participants commonly believed they were not at risk of HIV acquisition most of the time and thought that on-demand PrEP would be suitable as they tend to plan sexual activity in advance.
Preference for on-demand PrEP is high in young males. The qualitative data support a preference for on-demand PrEP in those who plan sex in advance. HIV intervention programs should offer both on-demand and daily PrEP to engage more adolescent boys and young men in HIV prevention practices.</description><subject>Adolescent</subject><subject>Adolescents</subject><subject>Adult</subject><subject>Analysis</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Biology and Life Sciences</subject><subject>Boys</subject><subject>Councils</subject><subject>Cross-Sectional Studies</subject><subject>Data collection</subject><subject>Demographics</subject><subject>Disease prevention</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health risks</subject><subject>HIV</subject><subject>HIV (Viruses)</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - prevention & control</subject><subject>HIV testing</subject><subject>Homosexuality, Male</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Male</subject><subject>Medical tests</subject><subject>Medicine and Health Sciences</subject><subject>Men</subject><subject>People and Places</subject><subject>Pre-Exposure Prophylaxis - methods</subject><subject>Preferences</subject><subject>Prevention</subject><subject>Prophylaxis</subject><subject>Qualitative analysis</subject><subject>Quantitative analysis</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Research ethics</subject><subject>Sex</subject><subject>Sexual and Gender Minorities</subject><subject>Sexually transmitted diseases</subject><subject>Social sciences</subject><subject>South Africa</subject><subject>STD</subject><subject>Teenagers</subject><subject>Variables</subject><subject>Young Adult</subject><subject>Young 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one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kakande, Ayoub</au><au>Ssemata, Andrew Sentoogo</au><au>Muhumuza, Richard</au><au>Atujuna, Millicent</au><au>Abaasa, Andrew</au><au>Ndekezi, Denis</au><au>Tshabalala, Gugulethu</au><au>Nematadzira, Teacler</au><au>Hornschuh, Stefanie</au><au>Nomvuyo, Mangxilana</au><au>Ahmed, Nadia</au><au>Maluadzi, Mamakiri</au><au>Anne Weiss, Helen</au><au>Webb, Emily</au><au>Stranix-Chibanda, Lynda</au><au>Janine Dietrich, Janan</au><au>Seeley, Janet</au><au>Fox, Julie</au><au>Matovu, Joseph K. B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preferences for oral PrEP dosing among adolescent boys and young men in three sub-Saharan African countries</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2023-10-09</date><risdate>2023</risdate><volume>18</volume><issue>10</issue><spage>e0285132</spage><epage>e0285132</epage><pages>e0285132-e0285132</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>HIV remains a leading contributor to the disease burden in sub-Saharan Africa, with adolescents and young people disproportionately affected. Optimising pre-exposure prophylaxis (PrEP) uptake has predominantly focused on women and adult men who have sex with men. We explore adolescent boys and young men's PrEP uptake preferences in South Africa, Uganda, and Zimbabwe.
A cross-sectional sequential exploratory mixed-methods study amongst males aged 13-24 years was conducted between April and September 2019 as part of the CHAPS trial. Group discussions (GDs) and In-Depth Interviews (IDIs) focused on motivations and hindrances for HIV testing, PrEP preference, and reasons for the uptake of PrEP. A thematic approach was used to analyse the qualitative data. A quantitative survey following the qualitative work covered questions on demographics, HIV risk and PrEP preferences (on-demand vs. daily). For quantitative analysis, we fitted logistic regression models to determine factors associated with on-demand vs daily PrEP preference.
Overall, 647 adolescent boys and young men (median age 20, IQR: 17-22) were enrolled. Of these, 422 (65.22%) preferred on-demand PrEP (South Africa 45.45%, Uganda 76.80%, Zimbabwe 70.35%; p<0.001). Factors independently associated with on-demand PrEP included country (South Africa, adjusted odds ratio (aOR) = 0.19 [95%CI:0.1-0.3] compared to Uganda) and advanced planning of sex [>24 hours in advance aOR = 1.4 (0.9-2.3) compared to <2 hours]. Qualitatively, participants commonly believed they were not at risk of HIV acquisition most of the time and thought that on-demand PrEP would be suitable as they tend to plan sexual activity in advance.
Preference for on-demand PrEP is high in young males. The qualitative data support a preference for on-demand PrEP in those who plan sex in advance. HIV intervention programs should offer both on-demand and daily PrEP to engage more adolescent boys and young men in HIV prevention practices.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>37812644</pmid><doi>10.1371/journal.pone.0285132</doi><tpages>e0285132</tpages><orcidid>https://orcid.org/0000-0003-1287-2634</orcidid><orcidid>https://orcid.org/0000-0003-3566-1688</orcidid><orcidid>https://orcid.org/0000-0002-0243-5601</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2023-10, Vol.18 (10), p.e0285132-e0285132 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2874788729 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Adolescent Adolescents Adult Analysis Anti-HIV Agents - therapeutic use Biology and Life Sciences Boys Councils Cross-Sectional Studies Data collection Demographics Disease prevention Female Health aspects Health risks HIV HIV (Viruses) HIV Infections - drug therapy HIV Infections - epidemiology HIV Infections - prevention & control HIV testing Homosexuality, Male Human immunodeficiency virus Humans Male Medical tests Medicine and Health Sciences Men People and Places Pre-Exposure Prophylaxis - methods Preferences Prevention Prophylaxis Qualitative analysis Quantitative analysis Regression analysis Regression models Research ethics Sex Sexual and Gender Minorities Sexually transmitted diseases Social sciences South Africa STD Teenagers Variables Young Adult Young adults Youth |
| title | Preferences for oral PrEP dosing among adolescent boys and young men in three sub-Saharan African countries |
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