{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T07:17:37Z","timestamp":1793431057711,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2020,6,30]],"date-time":"2020-06-30T00:00:00Z","timestamp":1593475200000},"content-version":"vor","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fogarty International Center of the National Institutes of Health","award":["R21-TW010897"],"award-info":[{"award-number":["R21-TW010897"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Adolescent girls and young women (AGYW) in sub\u2010Saharan Africa have emerged as a priority population in need of HIV prevention interventions. Secondary distribution of home\u2010based HIV self\u2010test kits by AGYW to male partners (MP) is a novel prevention strategy that complements pre\u2010exposure prophylaxis (PrEP), a female\u2010controlled prevention intervention. The objective of this analysis was to qualitatively operationalize two HIV prevention cascades through the lens of relationship dynamics for secondary distribution of HIV self\u2010tests to MP and PrEP for AGYW.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From April 2018 to December 2018, 2200 HIV\u2010negative AGYW aged 16\u201024\u00a0years were enrolled into an HIV prevention intervention which involved secondary distribution of self\u2010tests to MP and PrEP for AGYW; of these women, 91 participants or MP were sampled for in\u2010depth interviews based on their degree of completion of the two HIV prevention cascades. A grounded theory approach was used to characterize participants\u2019 relationship profiles, which were mapped to participants\u2019 engagement with the interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In cases where AGYW had a MP with multiple partners, AGYW perceived both interventions as inviting distrust into the relationship and insinuating non\u2010monogamy. Many chose not to accept either intervention, while others accepted and attempted to deliver the self\u2010test kit but received a negative reaction from their MP. In the few cases where AGYW held multiple partnerships, both interventions were viewed as mechanisms for protecting one\u2019s health, and these AGYW exhibited confidence in accepting and delivering the self\u2010test kits and initiating PrEP. Women who indicated intimate partner violence experiences chose not to accept either intervention because they feared it would elicit a violent reaction from their MP. For AGYW in relationships described as committed and emotionally open, self\u2010test kit delivery was completed with ease, but PrEP was viewed as unnecessary. MP experience with the cascade corroborated AGYW perspectives and demonstrated how men can perceive female\u2010initiated HIV prevention options as beneficial for AGYW and a threat to MP masculinity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Screening to identify AGYW relationship dynamics can support tailoring prevention services to relationship\u2010driven barriers and facilitators. HIV prevention counseling for AGYW should address relationship goals or partner\u2019s influence, and engage with MP around female\u2010controlled prevention interventions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25521","type":"journal-article","created":{"date-parts":[[2020,6,30]],"date-time":"2020-06-30T12:47:53Z","timestamp":1593521273000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Qualitative characterizations of relationships among South African adolescent girls and young women and male partners: implications for engagement across HIV self\u2010testing and pre\u2010exposure prophylaxis prevention cascades"],"prefix":"10.1002","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5654-5574","authenticated-orcid":false,"given":"Leah E","family":"Holmes","sequence":"first","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle R","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Department of Health. Behavior &amp; Society Johns Hopkins Bloomberg School of Public Health Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Casella","sequence":"additional","affiliation":[{"name":"Department of Health. Behavior &amp; Society Johns Hopkins Bloomberg School of Public Health Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mutsa","family":"Mudavanhu","sequence":"additional","affiliation":[{"name":"Witkoppen Health and Welfare Clinic Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian","family":"Mutunga","sequence":"additional","affiliation":[{"name":"Witkoppen Health and Welfare Clinic Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara","family":"Polzer","sequence":"additional","affiliation":[{"name":"Social Surveys Africa Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Bassett","sequence":"additional","affiliation":[{"name":"Witkoppen Health and Welfare Clinic Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annelies","family":"Van Rie","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Social Medicine University of Antwerp Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheree","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.18.2.19408"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.18.4.20227"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.2015.v105i11.10099"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/13691058.2012.667575"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-6402.2009.01538.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60548-X"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16098-4"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1011.040252"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(16)00041-2"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-4124-y"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0130216"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/1759-5436.12068"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32835f1d8c"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.19.7.21101"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2016.0098"},{"key":"e_1_2_9_17_1","unstructured":"BaetenJ HeffronR KidoguchiL MugoN KatabiraE BukusiE et al.Near elimination of HIV transmission in a demonstration project of PrEP and ART. 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