{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T17:31:56Z","timestamp":1788629516195,"version":"build-2803163510"},"reference-count":78,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,7,24]],"date-time":"2022-07-24T00:00:00Z","timestamp":1658620800000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Community\u2010based delivery of HIV pre\u2010exposure prophylaxis (PrEP) to South African adolescent girls and young women's (AGYW) could increase access but needs evaluation. We integrated PrEP services via home\u2010based services and pop\u2010up tents into existing community\u2010based HIV testing services (CB\u2010HTS) in Eastern Cape Province, South Africa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>After accessing CB\u2010HTS via a \u201cpop\u2010up\u201d tent or home\u2010based services, HIV\u2010negative AGYW aged 16\u201325 years were invited to complete a baseline questionnaire and referred for PrEP services at a community\u2010based PrEP site co\u2010located with pop\u2010up HTS tents. A 30\u2010day supply of PrEP was dispensed. PrEP uptake, time\u2010to\u2010initiation, cohort characteristics and first medication refill within 90 days were measured using descriptive statistics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 1164 AGYW who tested for HIV, 825 (74.3%) completed a questionnaire and 806 (97.7%) were referred for community\u2010based PrEP. Of those, 624 (77.4%) presented for PrEP (482\/483 [99.8%] from pop\u2010up HTS and 142\/323 [44.0%] from home\u2010based HTS), of which 603 (96.6%) initiated PrEP. Of those initiating PrEP following home\u2010based HTS, 59.1% initiated within 0\u20133 days, 25.6% within 4\u201314 days and 15.3% took \u226515 days to initiate; 100% of AGYW who used pop\u2010up HTS initiated PrEP the same day. Among AGWY initiating PrEP, 37.5% had a detectable sexually transmitted infection (STI). Although AGYW reported a low self\u2010perception of HIV risk, post\u2010hoc application of HIV risk assessment measures to available data classified most study participants as high risk for HIV acquisition. Cumulatively, 329 (54.6%) AGYW presented for a first medication refill within 90 days of accepting their first bottle of PrEP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Leveraging CB\u2010HTS platforms to provide same\u2010day PrEP initiation and refill services was acceptable to AGYW. A higher proportion of AGYW initiated PrEP when co\u2010located with CB\u2010HTS sites compared to those referred following home\u2010based HTS, suggesting that proximity of CB\u2010HTS and PrEP services facilitates PrEP uptake among AGYW. The high prevalence of STIs among those initiating PrEP necessitates the integration of STI and HIV prevention programs for AGYW. Eligibility for PrEP initiation should not be required among AHYW in high HIV burden communities. Community\u2010based service delivery will be crucial to maintaining access to PrEP services during the COVID\u201019 pandemic and future health and humanitarian emergencies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25968","type":"journal-article","created":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T06:14:00Z","timestamp":1658729640000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Acceptability and feasibility of leveraging community\u2010based HIV counselling and testing platforms for same\u2010day oral PrEP initiation among adolescent girls and young women in Eastern Cape, South Africa"],"prefix":"10.1002","volume":"25","author":[{"given":"Andrew","family":"Medina\u2010Marino","sequence":"first","affiliation":[{"name":"Desmond Tutu HIV Centre University of Cape Town Cape Town South Africa"},{"name":"Research Unit Foundation for Professional Development, Buffalo City Metro Eastern Cape Province South Africa"},{"name":"Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Bezuidenhout","sequence":"additional","affiliation":[{"name":"Research Unit Foundation for Professional Development, Buffalo City Metro Eastern Cape Province South Africa"},{"name":"Department of Epidemiology Mailman School of Public Health Columbia University New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phuti","family":"Ngwepe","sequence":"additional","affiliation":[{"name":"Research Unit Foundation for Professional Development, Buffalo City Metro Eastern Cape Province South Africa"},{"name":"Department of Statistical Sciences University of Cape Town Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charl","family":"Bezuidenhout","sequence":"additional","affiliation":[{"name":"Research Unit Foundation for Professional Development, Buffalo City Metro Eastern Cape Province South Africa"},{"name":"School of Public Health Boston University Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley N.","family":"Facente","sequence":"additional","affiliation":[{"name":"School of Public Health University of California Berkeley California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selly","family":"Mabandla","sequence":"additional","affiliation":[{"name":"HIV\/AIDS STIs and TB Program Buffalo City Metro Health District Eastern Cape Province Department of Health Bhisho South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sybil","family":"Hosek","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry and Infectious Disease Stroger Hospital of Cook County Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Little","sequence":"additional","affiliation":[{"name":"Department of Statistical Sciences University of Cape Town Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Connie L.","family":"Celum","sequence":"additional","affiliation":[{"name":"Department of Global Health, Medicine and Epidemiology University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda\u2010Gail","family":"Bekker","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre University of Cape Town Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,24]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"Miles to go: closing gaps, breaking barriers, righting injustices","author":"Joint UN Programme on HIV\/AIDS","year":"2018"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(19)30410-3"},{"key":"e_1_2_12_4_1","unstructured":"SimbayiL ZumaK ZunguN MoyoS MarindaE JoosteS et\u00a0al.South African National HIV Prevalence Incidence Behaviour and Communication Survey 2017: towards achieving the UNAIDS 90\u201090\u201090 targets. 2019 [cited 2021 Apr 4]. 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