ArticlePloS one2023
PrEP uptake and early persistence among adolescent girls and young women receiving services via community and hybrid community-clinic models in Namibia.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 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
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Effectiveness of community-based PrEP delivery for men who have sex with men: a global systematic review and meta-analysis.Frontiers in public health · 2026Pooled it
- Effect of a Peer Support Intervention for Oral Pre-Exposure Prophylaxis Uptake and Adherence Among Adolescent Girls and Young Women at Risk of HIV Acquisition in Kampala, Uganda: A Randomized Controlled Trial.Journal of the International AIDS Society · 2026Trial
- Article
- Determinants of PrEP Delivery Platform Choice in Adolescents and Young People: The Fast-PrEP Project in Cape Town, South Africa.International journal of environmental research and public health · 2026Article
- 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
- Article
- Review
- Expanding PrEP Access Through Decentralized Delivery Models.Current HIV/AIDS reports · 2026Review
- 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
- Study-to-Clinic Transition and Daily Oral PrEP Access Experiences Among AGYW in Eastern Cape, South Africa: Insights from the Community PrEP Study.AIDS and behavior · 2025Article
- Mobile Health Intervention Tools Promoting HIV Pre-Exposure Prophylaxis Among Adolescent Girls and Young Women in Sub-Saharan Africa: Scoping Review.JMIR mHealth and uHealth · 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
- Factors associated with the initiation of daily oral pre-exposure prophylaxis among adolescent girls and young women: findings from the Namibia DREAMS program.Frontiers in public health · 2025Article
- "When he is around, I'll take the PrEP, but when he is not, I will not take PrEP": key influences on PrEP use decisions among women attending family planning clinics in Kenya.Frontiers in medicine · 2025Article
- HIV interventions across the care continuum for adolescents in high-burden countries: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
Corrections and comments
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Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
Abstract
introductionAdolescent girls and young women (AGYW) face barriers in accessing clinic-based HIV pre-exposure prophylaxis (PrEP) services and community-based models are a proposed alternative. Evidence from such models, however, is limited. We evaluated PrEP service coverage, uptake, and early persistence among AGYW receiving services through community and hybrid models in Namibia.
methodsWe analyzed routine data for AGYW aged 15-24 who initiated PrEP within HIV prevention programming. PrEP was delivered via three models: community-concierge (fully community-based services with individually-tailored refill locations), community-fixed (community-based initiation and refills delivered by community providers on a set schedule at fixed sites), and hybrid community-clinic (community-based initiation and referral to clinics for refills delivered by clinic providers). We examined proportions of AGYW engaged in services along a programmatic PrEP cascade, overall and by model, and assessed factors associated with PrEP uptake and early persistence (refill within 15-44 days after initiation) using multivariable generalized estimating equations.
resultsOver 10-months, 7593 AGYW participated in HIV prevention programming. Of these, 7516 (99.0%) received PrEP education, 6105 (81.2%) received HIV testing services, 6035 (98.9%) tested HIV-negative, and 2225 (36.9%) initiated PrEP. Of the 2047 AGYW expected for PrEP refill during the study period, 254 (12.4%) persisted with PrEP one-month after initiation. Structural and behavioral HIV risk factors including early school dropout, food insecurity, inconsistent condom use, and transactional sex were associated with PrEP uptake. AGYW who delayed starting PrEP were 2.89 times more likely to persist (95% confidence interval (CI): 1.52-5.46) and those receiving services via the community-concierge model were 8.7 times (95% CI: 5.44-13.9) more likely to persist (compared to the hybrid model).
conclusionCommunity-based models of PrEP service delivery to AGYW can achieve high PrEP education and HIV testing coverage and moderate PrEP uptake. AGYW-centered approaches to delivering PrEP refills can promote higher persistence.
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