Other Titles
Adolescent Girls’ Adherence to PrEP in Sub-Saharan Africa: A Meta-Aggregation of Mixed Methods Studies [Title Slide]
Abstract
Background: Sub-Saharan Africa (SSA) is home to 25.9 million people living with HIV, with adolescent girls accounting for 63% of new infections [1,2]. These girls face risks compounded by gender-based violence, and limited sexual education [3]. Pre-exposure Prophylaxis (PrEP), estimated to be 99% effective in preventing HIV from intercourse and 77% from injectable drug use, is a promising prevention strategy [4]. Despite its efficacy, PrEP uptake and adherence among adolescent girls in SSA remain low [3]. This meta-aggregative review synthesizes evidence on PrEP uptake, adherence, facilitators, and barriers among adolescent girls, addressing a critical gap in research.
Methods: This meta-aggregative review followed Joana Briggs Institute guidelines as proposed by Munn et al. [9]. It include clear objective and question, eligibility criteria, and a comprehensive search across Scopus, PubMed, Embase, Web of Science, and other sources. Studies were quality-appraised, and data were analyzed thematically. Findings were synthesized and reported per PRISMA guidelines [10]. The review is registered with the Open Science Framework (DOI: https://doi.org/10.17605/OSF.IO/AUJZH).
Results: PrEP uptake rates among adolescent girls ranged from 4% to 95%. Health service factors including service delivery and drug-related factors, as well as personal factors comprising psychological issues such as depression, high behavioural HIV risk such as intimate partner violence, and socio-demographic characteristics influenced PrEP uptake. The rate of PrEP adherence drops substantially from 89% at one week to 9% after 12 months. Enablers of PrEP adherence include personal characteristics, HIV risk perception, adherence strategies, supportive networks, and health system factors. Barriers to PrEP adherence encompasses personal and psychosocial factors, accessibility issues, interpersonal challenges, and health provider-related matters.
Conclusion: PrEP uptake and adherence among adolescent girls in SSA vary significantly. This variability impacts efforts to achieve the SDG target of eliminating new HIV infections. To improve PrEP uptake and adherence, there is a need for age-specific and context-sensitive strategies tailored to adolescent girls in SSA.
Notes
References:
[1] Sabo KG, Seifu BL, Kase BF, Asebe HA, Asmare ZA, Asgedom YS, et al. Factors influencing HIV testing uptake in Sub-Saharan Africa: a comprehensive multi-level analysis using demographic and health survey data (2015–2022). BMC Infect Dis 2024;24:821. https://doi.org/10.1186/s12879-024-09695-1.
[2] UNAIDS. Fact sheets: Global HIV statistics. UNAIDS 2024 Epidemiological Estimates 2024:1–3. https://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf (accessed September 18, 2024).
[3] Abu-Ba’are GR, Shamrock OW, Rodriguez D, Agbemedu GRK, Nelson LE. Adolescent HIV prevent and care framework: A global scoping review protocol- BSGH 006. PLoS One 2024;19:1–9. https://doi.org/10.1371/journal.pone.0289994.
[4] Murewanhema G, Musuka G, Moyo P, Moyo E, Dzinamarira T. HIV and adolescent girls and young women in Sub Saharan Africa: A call for expedited action to reduce new infections. IJID Regions 2022;5:30–2. https://doi.org/10.1016/j.ijregi.2022.08.009.
[5] Lockwood C, Munn Z, Porritt K. Qualitative research synthesis: methodological guidance for systematic reviewers utilizing meta-aggregation. Int J Evid Based Healthc 2015;13:179–87.
[6] Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. BMJ (Online) 2009;339:332–6. https://doi.org/10.1136/bmj.b2535.
Sigma Membership
Omicron at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Mixed/Multi Method Research
Keywords:
Pre-Exposure Prophylaxis, PrEP, Uptake, Adherence, Adolescents Girls, Policy and Advocacy, Public and Community Health, Sustainable Development Goals
Recommended Citation
Abraham, Susanna Aba; Agyare, Dorcas Frempomaa; Anumel, Benjamin Kofi; and Amoadu, Mustapha, "Adolescent Girls’ Uptake of PrEP in Sub-Saharan Africa: A Meta-Aggregation of Mixed Methods Studies" (2025). Biennial Convention (CONV). 102.
https://www.sigmarepository.org/convention/2025/presentations_2025/102
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-11-24
Adolescent Girls’ Uptake of PrEP in Sub-Saharan Africa: A Meta-Aggregation of Mixed Methods Studies
Indianapolis, Indiana, USA
Background: Sub-Saharan Africa (SSA) is home to 25.9 million people living with HIV, with adolescent girls accounting for 63% of new infections [1,2]. These girls face risks compounded by gender-based violence, and limited sexual education [3]. Pre-exposure Prophylaxis (PrEP), estimated to be 99% effective in preventing HIV from intercourse and 77% from injectable drug use, is a promising prevention strategy [4]. Despite its efficacy, PrEP uptake and adherence among adolescent girls in SSA remain low [3]. This meta-aggregative review synthesizes evidence on PrEP uptake, adherence, facilitators, and barriers among adolescent girls, addressing a critical gap in research.
Methods: This meta-aggregative review followed Joana Briggs Institute guidelines as proposed by Munn et al. [9]. It include clear objective and question, eligibility criteria, and a comprehensive search across Scopus, PubMed, Embase, Web of Science, and other sources. Studies were quality-appraised, and data were analyzed thematically. Findings were synthesized and reported per PRISMA guidelines [10]. The review is registered with the Open Science Framework (DOI: https://doi.org/10.17605/OSF.IO/AUJZH).
Results: PrEP uptake rates among adolescent girls ranged from 4% to 95%. Health service factors including service delivery and drug-related factors, as well as personal factors comprising psychological issues such as depression, high behavioural HIV risk such as intimate partner violence, and socio-demographic characteristics influenced PrEP uptake. The rate of PrEP adherence drops substantially from 89% at one week to 9% after 12 months. Enablers of PrEP adherence include personal characteristics, HIV risk perception, adherence strategies, supportive networks, and health system factors. Barriers to PrEP adherence encompasses personal and psychosocial factors, accessibility issues, interpersonal challenges, and health provider-related matters.
Conclusion: PrEP uptake and adherence among adolescent girls in SSA vary significantly. This variability impacts efforts to achieve the SDG target of eliminating new HIV infections. To improve PrEP uptake and adherence, there is a need for age-specific and context-sensitive strategies tailored to adolescent girls in SSA.
Description
Adolescent girls in Sub-Saharan Africa face significant barriers to PrEP uptake and adherence, with rates varying widely from 4% to 95% and adherence dropping from 89% at one week to 9% at 12 months. Key enablers include supportive networks and adherence strategies, while barriers encompass psychosocial, accessibility, and health system challenges. Age-specific, context-sensitive interventions are essential to improve uptake and adherence, advancing progress toward eliminating new HIV infection.