Low awareness and use of pre-exposure prophylaxis among adolescents and young adults in high HIV and sexual violence prevalence settings

Abstract

South Africa has adopted pre-exposure prophylaxis (PrEP) as a preventive strategy for populations at-risk for HIV, though uptake is low among adolescents and young adults. We examined the awareness and use of PrEP among adolescents and young adults in the Eastern Cape, South Africa.This cross-sectional study was conducted between June and November 2018 among 772 adolescents and young adults (aged 16–24 years) selected using stratified random sampling in a South African university. An electronic self-administered questionnaire was used to elicit demographic information, behavioral, family-related characteristics, awareness and use of PrEP. Adjusted and unadjusted logistic regression models were used to examine the predictors of PrEP awareness.The overall level of PrEP awareness was 18.8%; however, only 1.7% of participants had used PrEP, 7.5% of had seen it, 4.8% knew how much it cost, and 14.8% knew where and how to get it. In the adjusted regression analysis, only adequate family support (AOR: 2.11; CI: 1.47–3.04) and discussions of HIV and sexually transmitted infections with sexual partners (AOR: 1.78; CI: 1.19–2.67) were associated with a higher likelihood of being aware of PrEP.The level of awareness and use of PrEP is still very low among adolescents and young adults who may need it to prevent HIV infection. Poor awareness of PrEP among adolescents and young adults in high HIV risk settings may limit its use. Thus, concerted efforts are needed to promote awareness and access to PrEP among young South African adults.

Association between sexual violence and unintended pregnancy among adolescent girls and young women in South Africa

“…University students were recruited because of ease of accessibility and lack of funds for a household survey. The full details of the methodology for the study have been published elsewhere [45,46]. Only unmarried male and female students aged 15 to 24 years were eligible for the study.…”

Identifying Critical Attributes and Attribute-Levels for a Discrete Choice Experiment on Oral Pre-Exposure Prophylaxis (PrEP) Delivery Among Young People in Cape Town and Johannesburg, South Africa.

“…Even though DCEs are increasingly used in the eld of sexual and reproductive health, there is limited research on young people's PrEP preferences in developing countries. Young people are considered a high risk group of acquiring HIV infection and important bene ciaries in accessing PrEP, yet PrEP uptake is low amongst South African youth [17]. Amongst a sample of 772 young people aged 16-24 years in the Eastern Cape, South Africs, only 1.7% had used PrEP [17].…”

“…Young people are considered a high risk group of acquiring HIV infection and important bene ciaries in accessing PrEP, yet PrEP uptake is low amongst South African youth [17]. Amongst a sample of 772 young people aged 16-24 years in the Eastern Cape, South Africs, only 1.7% had used PrEP [17]. Once young people initiate on PrEP, a substantial proportion do not persist with it [43].…”

“…PrEP was made sequentially available in the public sector in South Africa in 2016 to sex workers, MSM, sero-discordant couples, and most recently to young women and adolescent girls [16]. However, there is still a lack of awareness and uptake of PrEP among young South Africans [17]. The expansion of PrEP is urgently required across SSA, but can only be optimised by understanding barriers to PrEP uptake in young people.…”

Association between sexual violence and unintended pregnancy among adolescent girls and young women in South Africa

“…University students were recruited because of ease of accessibility and lack of funds for a household survey. The full details of the methodology for the study have been published elsewhere [43,44]. Only unmarried male and female students aged 15 to 24 years were eligible for the study.…”