{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T02:58:37Z","timestamp":1791514717646,"version":"4.3.4"},"reference-count":61,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,3,6]],"date-time":"2020-03-06T00:00:00Z","timestamp":1583452800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006492","name":"Division of Intramural Research, National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["UM1\u2010AI068619"],"award-info":[{"award-number":["UM1\u2010AI068619"]}],"id":[{"id":"10.13039\/100006492","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006492","name":"Division of Intramural Research, National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["UM1\u2010AI068617"],"award-info":[{"award-number":["UM1\u2010AI068617"]}],"id":[{"id":"10.13039\/100006492","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006492","name":"Division of Intramural Research, National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["UM1\u2010AI068613"],"award-info":[{"award-number":["UM1\u2010AI068613"]}],"id":[{"id":"10.13039\/100006492","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006492","name":"Division of Intramural Research, National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["T32\u2010AI007140\u201042"],"award-info":[{"award-number":["T32\u2010AI007140\u201042"]}],"id":[{"id":"10.13039\/100006492","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["F31MH113420"],"award-info":[{"award-number":["F31MH113420"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Stigma and disclosure concerns have been key barriers to oral pre\u2010exposure prophylaxis (PrEP) adherence for African adolescent girls and young women (AGYW) in efficacy trials. We aimed to understand the impact of these factors among African AGYW in an open\u2010label PrEP study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>HPTN 082 was an open\u2010label PrEP study among AGYW (ages 16 to 24) in Harare, Zimbabwe, and Cape Town and Johannesburg, South Africa from 2016 to 2018. Women starting PrEP were randomized to standard adherence support (counselling, two\u2010way SMS, monthly adherence clubs) or standard support plus drug\u2010level feedback. Serial in\u2010depth interviews were conducted among 67 AGYW after 13\u2010week and 26\u2010week study visits to explore experiences of stigma, disclosure and PrEP adherence. We analysed data by coding transcripts and memo\u2010writing and diagramming to summarize themes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>AGYW described stigma related to sexual activity (e.g. \u201cpeople say I'm a prostitute\u201d) and being perceived to be living with HIV because of taking antiretrovirals (e.g. \u201cmy husband's friends say I'm HIV infected\u201d). Participants who anticipated stigma were reluctant to disclose PrEP use and reported adherence challenges. Disclosure also resulted in stigmatizing experiences. Across all sites, negative descriptions of stigma and disclosure challenges were more common in the first interview. In the second interview, participants often described disclosure as an \u201cempowering\u201d way to combat community\u2010level PrEP stigma; many said that they proactively discussed PrEP in their communities (e.g. became a \u201ccommunity PrEP ambassador\u201d), which improved their ability to take PrEP and encourage others to use PrEP. These empowering disclosure experiences were facilitated by ongoing HPTN 082 study activities (e.g. counselling sessions, adherence clubs) in which they could discuss PrEP\u2010related stigma, disclosure and PrEP adherence issues.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Stigma and disclosure challenges were initial concerns for African AGYW newly initiating PrEP but many were empowered to disclose PrEP use over their first six months of PrEP use, which helped them cope with stigma and feel more able to take PrEP regularly. PrEP programmes can foster disclosure through community and clinic\u2010based discussion, adherence clubs and activities normalizing sexual behaviour and PrEP use, which can reduce stigma and improve PrEP adherence and thus effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.25463","type":"journal-article","created":{"date-parts":[[2020,3,6]],"date-time":"2020-03-06T23:05:32Z","timestamp":1583535932000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":191,"title":["The influence of HIV\u2010related stigma on PrEP disclosure and adherence among adolescent girls and young women in HPTN 082: a qualitative study"],"prefix":"10.1002","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7242-7415","authenticated-orcid":false,"given":"Jennifer","family":"Velloza","sequence":"first","affiliation":[{"name":"University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nomhle","family":"Khoza","sequence":"additional","affiliation":[{"name":"Wits Reproductive Health &amp; HIV Institute (Wits RHI) Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Scorgie","sequence":"additional","affiliation":[{"name":"Wits Reproductive Health &amp; HIV Institute (Wits RHI) Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miria","family":"Chitukuta","sequence":"additional","affiliation":[{"name":"Clinical Trials Research Centre University of Zimbabwe College of Health Sciences Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prisca","family":"Mutero","sequence":"additional","affiliation":[{"name":"Clinical Trials Research Centre University of Zimbabwe College of Health Sciences Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kudzai","family":"Mutiti","sequence":"additional","affiliation":[{"name":"Clinical Trials Research Centre University of Zimbabwe College of Health Sciences Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nomvuyo","family":"Mangxilana","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Foundation Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lumka","family":"Nobula","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Foundation Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle A","family":"Bulterys","sequence":"additional","affiliation":[{"name":"University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Millicent","family":"Atujuna","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Foundation Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sybil","family":"Hosek","sequence":"additional","affiliation":[{"name":"Stroger H. Hospital of Cook County Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6039-0352","authenticated-orcid":false,"given":"Renee","family":"Heffron","sequence":"additional","affiliation":[{"name":"University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda\u2010Gail","family":"Bekker","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences Institute of Infectious Disease and Molecular Medicine University of Cape Town Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nyaradzo","family":"Mgodi","sequence":"additional","affiliation":[{"name":"Clinical Trials Research Centre University of Zimbabwe College of Health Sciences Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Chirenje","sequence":"additional","affiliation":[{"name":"Clinical Trials Research Centre University of Zimbabwe College of Health Sciences Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8813-3419","authenticated-orcid":false,"given":"Connie","family":"Celum","sequence":"additional","affiliation":[{"name":"University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinead","family":"Delany\u2010Moretlwe","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the HPTN 082 study group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00056-2"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1108524"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1110711"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1011205"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1202614"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1402269"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0089118"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000880"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68184-1"},{"issue":"3","key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"19356","DOI":"10.7448\/IAS.17.3.19356","article-title":"Women and ARV\u2010based HIV prevention \u2010 challenges and opportunities","volume":"17","author":"Geary CW","year":"2014","journal-title":"J Int AIDS Soc"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-018-0385-0"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-015-1129-4"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-016-1466-y"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1690-0"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/1557988318797437"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(17)30156-X"},{"key":"e_1_2_9_18_1","unstructured":"GillK DietrichJ GrayG PidwellT KayambaE BennieT et al.Pluspills: an open label safety and feasibility study of oral pre\u2010exposure prophylaxis (PrEP) in 15\u201319 year old adolescents in two sites in South Africa. Abstract #TUAC0207LB. 9th International AIDS Society Conference (IAS) on HIV Science; July 23\u201326;Paris France:2017."},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-016-1458-y"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2018.0058"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(19)30002-5"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.4172\/2155-6113.1000730"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-018-2371-3"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1675-z"},{"key":"e_1_2_9_25_1","first-page":"241","article-title":"Preexposure prophylaxis\u2010related stigma: strategies to improve uptake and adherence \u2010 a narrative review","volume":"7","author":"Haire BG","year":"2015","journal-title":"HIVAIDS"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001762"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25323"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-012-0317-8"},{"issue":"3","key":"e_1_2_9_29_1","doi-asserted-by":"crossref","first-page":"19146","DOI":"10.7448\/IAS.17.3.19146","article-title":"Perspectives on the use of oral and vaginal antiretrovirals for HIV prevention: the VOICE\u2010C qualitative study in Johannesburg, South Africa","volume":"17","author":"Van der Straten A","year":"2014","journal-title":"J Int AIDS Soc"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0191251"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0212271"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-018-2159-5"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2017.0153"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000974"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1089\/trgh.2019.0014"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-019-00371-3"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiw077"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001511"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01710-17"},{"key":"e_1_2_9_40_1","volume-title":"The discovery of grounded theory, strategies for qualitative research","author":"Glaser B","year":"1967"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2006.00684.x"},{"key":"e_1_2_9_42_1","volume-title":"Qualitative data analysis: a methods sourcebook","author":"Miles MB","year":"2013"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-016-1954-1"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1474746407003880"},{"key":"e_1_2_9_45_1","unstructured":"CelumCL Delany\u2010MoretlweS HosekSG DyeBJ BekkerLG MgodiNM et al.Risk behavior perception and reasons for PrEP among young African women in HPTN 082. Abstract #1049. Conference on Retroviruses and Opportunistic Infections 2018 (CROI); March 4\u20107 2018;Boston Massachusetts USA."},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-014-0950-5"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-015-1690-9"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1964-6"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.4102\/sajhivmed.v17i1.455"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1071\/SH18125"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1071\/SH18064"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001850"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001830"},{"key":"e_1_2_9_54_1","unstructured":"TravillD BekkerLG Delaney\u2010MoretlweS BukusiE ImrieJ Rousseau\u2010JemwaE et al.Sexual behavior and PrEP uptake among young African women in a demonstration project about PrEP delivery. Abstract #WEPEC219. International AIDS Society Conference (IAS 2018); July 23\u201027 2018;Amsterdam The Netherlands."},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1080\/10410236.2016.1140271"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2019.1571090"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1071\/SH18055"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.2196\/10694"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.2196\/mhealth.7199"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1071\/SH18084"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000567"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181b9300c"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.25463","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jia2.25463","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.25463","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T04:13:27Z","timestamp":1695874407000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.25463"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3]]},"references-count":61,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1002\/jia2.25463"],"URL":"https:\/\/doi.org\/10.1002\/jia2.25463","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3]]},"assertion":[{"value":"2019-09-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e25463"}}