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Rethinking HIV prevention to prepare for oral PrEP implementation for young African women

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dc.date.accessioned 2015-08-27 en
dc.date.accessioned 2016-12-04T13:22:04Z
dc.date.available 2016-12-04T13:22:04Z
dc.date.issued 2015-09-07 en
dc.identifier.uri http://hdl.handle.net/20.500.11910/1812
dc.description.abstract HIV incidence remains high among young women in sub-Saharan Africa in spite of scale-up of HIV testing, behavioural interventions, antiretroviral treatment and medical male circumcision. There is a critical need to critique past approaches and learn about the most effective implementation of evidence-based HIV prevention strategies, particularly emerging interventions such as pre-exposure prophylaxis (PrEP). Women in sub-Saharan Africa are at increased risk of HIV during adolescence and into their 20s, in part due to contextual factors including gender norms and relationship dynamics, and limited access to reproductive and sexual health services. We reviewed behavioural, behavioural economic and biomedical approaches to HIV prevention for young African women, with a particular focus on the barriers, opportunities and implications for implementing PrEP in this group. Behavioural interventions have had limited impact in part due to not effectively addressing the context, broader sexual norms and expectations, and structural factors that increase risk and vulnerability. Of biomedical HIV prevention strategies that have been tested, daily oral PrEP has the greatest evidence for protection, although adherence was low in two placebo-controlled trials in young African women. Given high efficacy and effectiveness in other populations, demonstration projects of open-label PrEP in young African women are needed to determine the most effective delivery models and whether women at substantial risk are motivated and able to use oral PrEP with sufficient adherence to achieve HIV prevention benefits. Social marketing, adherence support and behavioural economic interventions should be evaluated as part of PrEP demonstration projects among young African women in terms of their effectiveness in increasing demand and optimizing uptake and effective use of PrEP. Lessons learned through evaluations of implementation strategies for delivering oral PrEP, a first generation biomedical HIV prevention product, will inform development of new and less user-dependent PrEP formulations and delivery of an expanding choice of prevention options in HIV prevention programmes for young African women. en
dc.format.medium Print en
dc.publisher International Aids Society en
dc.subject WOMEN en
dc.subject HIV/AIDS en
dc.subject YOUTH en
dc.title Rethinking HIV prevention to prepare for oral PrEP implementation for young African women en
dc.type Journal Article en
dc.description.version Y en
dc.ProjectNumber N/A en
dc.Volume 18(3) en
dc.BudgetYear 2015/16 en
dc.ResearchGroup HIV/AIDS, STIs and TB en
dc.ResearchGroup Human and Social Development en
dc.SourceTitle Journal of the International AIDS Society en
dc.PlaceOfPublication Geneva, Switzerland en
dc.ArchiveNumber 8792 en
dc.PageNumber Online en
dc.outputnumber 7542 en
dc.bibliographictitle Celum, C.L., Delany-Moretlwe, S., McConell, M., Van Rooyen, H., Bekker, L-G., Kurth, A., Bukusi, E., Desmond, C., Morton, J. & Baeten, J.M. (2015) Rethinking HIV prevention to prepare for oral PrEP implementation for young African women. <i>Journal of the International AIDS Society</i>. 18(3):Online. en
dc.publicationyear 2015 en
dc.contributor.author1 Celum, C.L. en
dc.contributor.author2 Delany-Moretlwe, S. en
dc.contributor.author3 McConell, M. en
dc.contributor.author4 Van Rooyen, H. en
dc.contributor.author5 Bekker, L-G. en
dc.contributor.author6 Kurth, A. en
dc.contributor.author7 Bukusi, E. en
dc.contributor.author8 Desmond, C. en
dc.contributor.author9 Morton, J. en
dc.contributor.author10 Baeten, J.M. en

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