We choose: Adolescent girls and young women's choice for an HIV prevention product in a cross-over randomized clinical trial conducted in South Africa, Uganda, and Zimbabwe

• Published in: PloS one 2024-08, Vol.19 (8), p.e0308577
• Main Authors: Atujuna, Millicent, Williams, Kristin, Roberts, Sarah T, Young, Alinda, Browne, Erica N, Mangxilana, Nomvuyo T, Tenza, Siyanda, Shapley-Quinn, Mary Kate, Tauya, Thelma, Ngure, Kenneth, van der Straten, Ariane
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Adult; Anti-HIV Agents - therapeutic use; Beliefs, opinions and attitudes; Biology and Life Sciences; Choice Behavior; Choice learning; Cross-Over Studies; Data collection; Decision making; Disease prevention; Female; Focus Groups; Girls; Health aspects; HIV; HIV (Viruses); HIV Infections - prevention & control; Human immunodeficiency virus; Humans; Interviews; Medical innovations; Medicine and Health Sciences; Pre-Exposure Prophylaxis - methods; Preferences; Prevention; Prophylaxis; Pyrimidines; Qualitative research; Quality control; Research and Analysis Methods; Sexually transmitted diseases; Side effects; Social Sciences; South Africa; Teenage girls; Teenagers; Uganda; Young Adult; Young women; Zimbabwe
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0308577

With new pre-exposure prophylaxis (PrEP) modalities for HIV prevention becoming available, understanding how adolescent girls and young women (AGYW) navigate through PrEP options is essential, including factors underlying their choice. Through 16 focus group discussions (FGDs) and 52 in-depth interviews (IDIs) from REACH, an open-label crossover study in which AGYW were allocated 1:1 (between 06 February 2019 and 18 March 2020) to receive oral PrEP for six months and the dapivirine ring for six months, in a randomized sequence, followed by a 6-month period where either product (or neither) could be chosen, we explored decision-making process and product choice, using a mixed inductive-deductive analytical approach. Key themes included the desire to remain HIV-negative and weighing product attributes through experiential learning. Product triability appeared important in informing product choice as individual circumstances changed or assuaging side effects with a given product. Approved biomedical prevention innovations may also benefit from hands-on experience to help with adoption and use during real-world implementation. Furthermore, support from trusted providers will remain critical as AGYW contemplate navigating through PrEP options and choice.