ArticleFrontiers in reproductive health2022
Improving HIV pre-exposure prophylaxis persistence among adolescent girls and young women: Insights from a mixed-methods evaluation of community, hybrid, and facility service delivery models in Namibia.
Article in Frontiers in reproductive health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis 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
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Are facility service delivery models meeting the sexual and reproductive health needs of adolescents in Sub-Saharan Africa? A qualitative evidence synthesis.BMC health services research · 2025Pooled it
- A Dual Prevention Pill for HIV & Pregnancy Prevention: A Pilot Study Among Adolescent Girls and Young Women in Zimbabwe.AIDS and behavior · 2026Trial
- PrEP and Contraceptive Persistence Among Young Women Receiving Sexual and Reproductive Health Services Through Hair Salons in South Africa.Journal of acquired immune deficiency syndromes (1999) · 2026Trial
- Review
- Empowering Women's PrEP Choices: Qualitative Insights into Long-Acting PrEP Preferences and Decision-Making during Pregnancy and Breastfeeding in South Africa and Botswana.AIDS and behavior · 2026Article
- A primary health care Re-Engineering approach to enhance PrEP initiation and adherence among high-risk, sexually active adolescents and young adults in KwaZulu-Natal, South Africa.BMC public health · 2025Article
- Social Protection and HIV risk Factors among Youth in Southern Africa: An Analysis of Cross-sectional Population-based HIV Impact Assessment Surveys.AIDS and behavior · 2025Article
- One Month Preexposure Prophylaxis Retention Rate and Associated Factors Among Adolescent Girls and Young Women Who Participated in the Namibia DREAMS Program (2018-2024).Infectious disease reports · 2025Article
- Acceptability and Feasibility of Remote PrEP Visits for Adolescent Girls and Young Women in South Africa.AIDS and behavior · 2025Article
- PrEP Uptake and Utilisation Among Adolescent Girls and Young Women in Sub-Saharan Africa: A Scoping Review.AIDS and behavior · 2025Article
- Article
- "I will take PrEP because that's what will help me not to get infected with HIV": barriers to and facilitators of pre-exposure prophylaxis and condom use among adolescent girls and young women enrolled in a school-based HIV prevention program in South Africa.Frontiers in public health · 2025Article
- A qualitative study of peer education experiences and oral pre-exposure prophylaxis use among adolescent girls and young women at high risk of HIV acquisition in Kampala, Uganda.Frontiers in public health · 2025Article
- Engaging the private sector as part of HIV pre-exposure prophylaxis service delivery in Vietnam: a comparative analysis of uptake, persistence and HIV seroconversion from 2018 to 2023.Frontiers in reproductive health · 2024Article
- Prep provision in community organizations: a comparative study with conventional services.Revista de saude publica · 2024Article
- Awareness of Heightened Sexual and Behavioral Vulnerability as a Trigger for PrEP Resumption Among Adolescent Girls and Young Women in East and Southern Africa.Current HIV/AIDS reports · 2023Review
- Preferences, educational messaging, and demand creation channels for multipurpose-prevention technologies (MPTs) among women in South Africa.BMC public health · 2023Article
- Article
- Optimizing the pipeline of multipurpose prevention technologies: opportunities across women's reproductive lifespans.Frontiers in reproductive health · 2023Review
- Pre-exposure prophylaxis access, uptake and usage by young people: a systematic review of barriers and facilitators.Therapeutic advances in infectious diseaseReview
Corrections and comments
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Authors and funding
14 authors at 4 institutions in 2 countries.
Funding
Abstract
Introduction: Despite the potential for community-based approaches to increase access to pre-exposure prophylaxis (PrEP) for adolescent girls and young women (AGYW), there is limited evidence of whether and how they improve PrEP persistence. We compared PrEP persistence among AGYW receiving services through community and hybrid models in Namibia to facility-based services. We subsequently identify potential mechanisms to explain how and why community and hybrid models achieved (or not) improved persistence to inform further service delivery innovation. Methods: Data were collected from PrEP service delivery to AGYW over two-years in Namibia's Khomas Region. We used Kaplan-Meier analysis to estimate survival curves for PrEP persistence beyond three-months after initiation and report the cumulative probability of persistence at one- and three-months. Persistence was defined as any PrEP use within three months after initiation followed by a PrEP refill or previously prescribed supply of at least 30 days at the three-month visit. Interviews were conducted with 28 AGYW and 19 providers and analyzed using a deductive-inductive thematic approach. Results: From October 2017 through September 2019, 372 (18.7%) AGYW received services through a facility model, 302 (15.1%) through a community model, and 1,320 (66.2%) through a hybrid model. PrEP persistence at one- and three-months was 41.2% and 34.9% in the community model and 6.2% and 4.8% in the hybrid model compared to 36.8% and 26.7% in the facility model. Within the community and hybrid models, we identified three potential mechanisms related to PrEP persistence. Individualized service delivery offered Conclusion: Service delivery approaches that offer convenience and simplicity and foster social connectedness may reduce access barriers and increase social support enabling AGYW to self-manage their PrEP use and achieve improved PrEP persistence.
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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.