{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T14:01:31Z","timestamp":1783778491287,"version":"3.55.0"},"reference-count":32,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"unspecified","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MC_UU_00004\/03"],"award-info":[{"award-number":["MC_UU_00004\/03"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Second European & Developing Countries Clinical Trials Partnership","award":["RIA2016-1644"],"award-info":[{"award-number":["RIA2016-1644"]}]},{"name":"Gilead","award":["CO-UK-412-5430"],"award-info":[{"award-number":["CO-UK-412-5430"]}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["Strategic Core Award : 227167\/A\/23\/Z"],"award-info":[{"award-number":["Strategic Core Award : 227167\/A\/23\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,3,20]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"\n Introduction<\/jats:title>\n Ensuring the effectiveness of HIV prevention and treatment methods requires high levels of adherence. Studies have recognised the significance of trust in shaping HIV risk perception.<\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n In this qualitative analysis, our aim was to explore risk perceptions and understand how individuals assess and respond to HIV risks, as well as their uptake and adherence to oral pre-exposure prophylaxis (PrEP).<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n The study was based on the setting of an HIV prevention trial conducted in South Africa.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Thirty individuals, 9% of the total clinical trial participants, enrolled in the clinical trial were purposively selected and interviewed at three time points within the trial during the follow-up phase. Data analysis was conducted using the Trust, Confidence and Cooperation framework that included constructs of trust, confidence and cooperation.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The findings show that the ongoing participation in the clinical trial played a significant role in influencing participants\u2019 decision to continue PrEP as HIV prevention. This decision was grounded in their trust that PrEP would effectively reduce their vulnerability to HIV and infection.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Clear and consistent health-promoting initiatives enhance participants\u2019 self-awareness of HIV risks and promote understanding (uptake) and effectiveness of HIV prevention methods.<\/jats:p>\n <\/jats:sec>\n \n Trial registration number<\/jats:title>\n \n NCT04066881<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-086742","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T21:15:20Z","timestamp":1745442920000},"page":"e086742","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["HIV risk perception, trust and PrEP adherence among participants in an HIV prevention trial: a qualitative longitudinal study, South Africa"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct04066881","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04066881","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04066881","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4890-2105","authenticated-orcid":false,"given":"Rujeko Samanthia","family":"Chimukuche","sequence":"first","affiliation":[{"name":"Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa"},{"name":"Division of Infection & Immunity, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Londiwe","family":"Shandu","sequence":"additional","affiliation":[{"name":"Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silindile","family":"Zulu","sequence":"additional","affiliation":[{"name":"Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phindile","family":"Khanyile","sequence":"additional","affiliation":[{"name":"Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishanta","family":"Singh","sequence":"additional","affiliation":[{"name":"HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zakir","family":"Gaffoor","sequence":"additional","affiliation":[{"name":"HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5338-3517","authenticated-orcid":false,"given":"Rachel","family":"Kawuma","sequence":"additional","affiliation":[{"name":"Social Science, MRC\/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheena","family":"McCormack","sequence":"additional","affiliation":[{"name":"MRC Clinical Trials Unit, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0583-5272","authenticated-orcid":false,"given":"Janet","family":"Seeley","sequence":"additional","affiliation":[{"name":"Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa"},{"name":"Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,4,23]]},"reference":[{"key":"2025121604282280000_15.4.e086742.1","unstructured":"World Health Organisation . Policy brief: WHO expands recommendation on oral pre-exposure prophylaxis of HIV infection (PrEP). Geneva: World Health Organisation, 2015."},{"key":"2025121604282280000_15.4.e086742.2","unstructured":"World Health Organisation . Global health programme: pre-exposure prophylaxis (PrEP). Available: https:\/\/www.who.int\/teams\/global-hiv-hepatitis-and-stis-programmes\/hiv\/prevention\/pre-exposure-prophylaxis [Accessed 01 Mar 2024]."},{"key":"2025121604282280000_15.4.e086742.3","unstructured":"World Health Organisation . What\u2019s the 2+1+1? Event-driven oral pre-exposure prophylaxis to prevent HIV for men who have sex with men: update to WHO\u2019s recommendation on oral PrEP. 2019. Available: https:\/\/www.who.int\/publications\/i\/item\/what-s-the-2-1-1-event-driven-oral-pre-exposure-prophylaxis-to-prevent-hiv-for-men-who-have-sex-with-men [Accessed 10 Sep 2023]."},{"key":"2025121604282280000_15.4.e086742.4","unstructured":"PrEPWatch . Exploring data and information on PrEP across the globe. 2024. Available: https:\/\/www.prepwatch.org [Accessed 01 Mar 2024]."},{"key":"2025121604282280000_15.4.e086742.5","unstructured":"Joint United Nations Programme on HIV\/AIDS and the World Health Organization . Ethical considerations in HIV prevention trials. 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