ArticleJournal of the International AIDS Society2020
HIV risk, risk perception, and PrEP interest among adolescent girls and young women in Lilongwe, Malawi: operationalizing the PrEP cascade.
Article in Journal of the International AIDS Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
53 citing papers in PubMed, 3 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Interventions to Improve Adherence to Oral Pre-exposure Prophylaxis: A Systematic Review and Network Meta-analysis.AIDS and behavior · 2024Pooled it
- Pooled it
- Systematic review of the values and preferences regarding the use of injectable pre-exposure prophylaxis to prevent HIV acquisition.Journal of the International AIDS Society · 2023Pooled it
- Brief Report: HIV Risk Perception and Pre-Exposure Prophylaxis Uptake Among Pregnant Women Offered Pre-Exposure Prophylaxis During Antenatal Care in Kenya.Journal of acquired immune deficiency syndromes (1999) · 2025Trial
- Point-of-care testing for sexually transmitted infections and HIV pre-exposure prophylaxis among pregnant women in South Africa, 2021-2022: randomised controlled trial.Sexually transmitted infections · 2024Trial
- Trial
- Alignment of PrEP adherence with periods of HIV risk among adolescent girls and young women in South Africa and Zimbabwe: a secondary analysis of the HPTN 082 randomised controlled trial.The lancet. HIV · 2022Trial
- Understanding the Influence of PrEP Motivations and Concerns on PrEP Use Among Pregnant Women in Lilongwe, Malawi: A Mixed-Methods Study.AIDS and behavior · 2026Article
- A Systematic Review of Barriers and Facilitators to the Uptake and Adherence of Injectable PrEP Among Adolescent Girls and Young Women in Sub-Saharan Africa.AIDS and behavior · 2026Review
- Oral PrEP pause and restart among adolescent girls and young women (AGYW) who initiated PrEP in an HIV prevention program in Kampala, Uganda: a qualitative study.AIDS research and therapy · 2026Article
- Patterns of Sexual Behaviors and Sexual Partner Characteristics as Predictors of Perceived HIV Risk and HIV Status Among Adolescent Girls and Young Women in Kenya.AIDS and behavior · 2026Article
- Article
- Determinants of HIV testing and oral PrEP uptake among youth at Malawi University of Business and Applied Sciences: A cross-sectional study employing the Health Belief Model.PLOS global public health · 2026Article
- Barriers to and Facilitators of Heterosexual Men's Engagement with the PrEP Care Continuum in Sub-Saharan Africa: A Scoping Review.AIDS and behavior · 2026Article
- Appraising the HIV prevention cascade methodology to improve HIV prevention targets: Lessons learned from a general population pilot study in east Zimbabwe.PLOS global public health · 2026Article
- HIV Knowledge, Information Sources, and Perceived Risk among Reproductive-Aged Individuals in Kisumu, Kenya: A Latent Profile Analysis.AIDS and behavior · 2026Article
- Epidemiological impacts and cost-effectiveness of daily and on-demand oral pre-exposure prophylaxis among key HIV populations in China: An economic evaluation.Epidemiology and infection · 2025Article
- Article
- Efficacy of a Mobile Serious Game (SwaziYolo) for Increasing HIV Risk Perception: Randomized Controlled Trial.JMIR serious games · 2025Article
- Experiences of adolescent girls and young women of oral PrEP uptake in rural KwaZulu-Natal.African journal of primary health care & family medicine · 2025Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
introductionAs a user-controlled HIV prevention method, oral pre-exposure prophylaxis (PrEP) holds particular promise for adolescent girls and young women (AGYW). HIV prevention cascades, critical frameworks for the design and evaluation of PrEP programmes, outline the priorities of identifying individuals at greatest HIV risk and motivating them to initiate PrEP through perceived HIV risk. To inform future iterations of these cascades and PrEP delivery for AGYW, the objective of this study was to understand the level of interest in PrEP among AGYW at highest HIV risk, and the potential role of perceived risk in motivating PrEP interest.
methodsUsing data from a cohort study of HIV-negative AGYW in Lilongwe, Malawi (February 2016 to August 2017), we assessed the relationship between epidemiologic HIV risk (risk index developed in a previous analysis) and PrEP interest, and the extent to which perceived risk explains the relationship between HIV risk and PrEP interest. We further aimed to operationalize the pre-initiation steps of the HIV prevention cascade in the study population.
resultsIn total, 825 AGYW were included in analyses, of which 43% met the criterion for high epidemiologic HIV risk. While epidemiologic risk scores were positively associated with PrEP interest, high numbers of AGYW both above and below the high-risk cutoff were very interested in PrEP (68% vs. 63%). Perceived risk partially explained the relationship between HIV risk and PrEP interest; greater epidemiologic HIV risk was associated with high perceived risk, which was in turn associated with PrEP interest. Many more high-risk AGYW were interested in PrEP (68%) than expressed a high level of perceived HIV risk (26%).
conclusionsThese results highlight key relationships between epidemiologic HIV risk, risk perception and interest in PrEP. While risk perception did partially explain the relationship between epidemiologic risk and PrEP interest, there may be other important motivational mechanisms that are not captured in many HIV prevention cascades. The high number of participants with risk scores below the high-risk cutoff who both expressed high perceived risk and interest in PrEP suggests that demand for PrEP among AGYW may not be well aligned with epidemiologic risk.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.