{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T13:09:05Z","timestamp":1768568945598,"version":"3.49.0"},"reference-count":50,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T00:00:00Z","timestamp":1687478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["UM1AI068633,UM1AI068615,UM1AI106707"],"award-info":[{"award-number":["UM1AI068633,UM1AI068615,UM1AI106707"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute of Health"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Adolescent girls and young women (AGYW) in sub-Saharan Africa are disproportionately affected by the HIV epidemic and face an array of challenges using proven behavioral and biomedical prevention methods. To address the urgent need for expanding prevention options, we evaluated the baseline preferences of HIV prevention methods among participants enrolled in the MTN-034\/REACH crossover trial along with their stated product preference prior to product initiation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>AGYW aged 16\u201321 years were enrolled at 4 study sites: Cape Town and Johannesburg, South Africa; Kampala, Uganda; and Harare, Zimbabwe and randomly assigned to the sequence of using oral PrEP and the dapivirine ring for 6 months each, followed by a choice period in which they could choose either product (or neither) for an additional six months. Eligible AGYW were HIV-negative, not pregnant and using effective contraception for at least two months prior to enrollment. Descriptive statistics were used to summarize demographic and behavioral data while multinomial analysis was used to determine predictors of stated product preference (ring or oral PrEP).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of the 247 AGYW enrolled in REACH, 34% were aged 16\u201317 and 89% had a primary partner.The median age of sexual debut was 16 years and 40% had ever been pregnant. At screening, 35% of participants were diagnosed with a sexually transmitted infection (STI), 39% had an AUDIT-C score associated with harmful drinking and 11% reported intimate partner violence in the past 6 months. Overall, 28% of participants, had CESD-10 scores suggestive of depressive symptoms (\u226512) in the past week. At baseline, similar proportions stated a preference for the ring and oral PrEP (38.1% and 40.5% respectively), with 19% of participants stating they preferred both products equally. Only study site was significantly associated with product preference (P&lt;0.05) with AGYW from Johannesburg having higher odds of preferring the ring and those from Kampala having higher odds of preferring both options equally.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>We successfully enrolled African AGYW with a clear unmet need for HIV prevention. The balanced preference between the two products suggests that multiple biomedical prevention options may be appealing to this age group and could address their prevention needs.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0287525","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T23:25:52Z","timestamp":1687649152000},"page":"e0287525","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":18,"title":["Baseline preferences for oral pre-exposure prophylaxis (PrEP) or dapivirine intravaginal ring for HIV prevention among adolescent girls and young women in South Africa, Uganda and Zimbabwe (MTN-034\/IPM-045 study)"],"prefix":"10.1371","volume":"18","author":[{"given":"Kenneth","family":"Ngure","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara A.","family":"Friedland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel W.","family":"Szydlo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3318-9781","authenticated-orcid":true,"given":"Sarah T.","family":"Roberts","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morgan","family":"Garcia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Levy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyne A.","family":"Akello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krishnaveni","family":"Reddy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thesla","family":"Palanee-Phillips","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pippa","family":"Macdonald","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bekezela","family":"Siziba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lydia","family":"Soto-Torres","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sybil","family":"Hosek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon L.","family":"Hillier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gonasagrie","family":"Nair","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Connie","family":"Celum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariane","family":"van der Straten","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,6,23]]},"reference":[{"key":"pone.0287525.ref001","unstructured":"Global HIV & AIDS statistics \u2014 2020 fact sheet https:\/\/www.unaids.org\/en\/resources\/fact-sheet - Accessed on November 20, 2021"},{"key":"pone.0287525.ref002","unstructured":"UNAIDS. Women and HIV: a spotlight on adolescent girls and young women. UNAIDS. 2019. https:\/\/www.unaids.org\/en\/resources\/documents\/2019\/women-and-hiv Accessed on November 20, 2021"},{"key":"pone.0287525.ref003","doi-asserted-by":"crossref","first-page":"S17","DOI":"10.1097\/QAI.0000000000001316","article-title":"Prevention of HIV in adolescent girls and young women: key to an AIDS-free generation","volume":"75","author":"QA Karim","year":"2017","journal-title":"JAIDS Journal of Acquired Immune Deficiency Syndromes"},{"key":"pone.0287525.ref004","doi-asserted-by":"crossref","first-page":"19408","DOI":"10.7448\/IAS.18.2.19408","article-title":"Adolescent girls and young women: key populations for HIV epidemic control","volume":"18","author":"RC Dellar","year":"2015","journal-title":"Journal of the International AIDS Society"},{"key":"pone.0287525.ref005","unstructured":"Gilead Sciences, Inc. U.S. Food and Drug Administration Approves Gilead\u2019s Truvada for Reducing the Risk of Acquiring HIV (Press Release). July 16, 2012. http:\/\/www.gilead.com\/news\/press-releases\/2012\/7\/us-food-and-drugadministration-approves-gileads-truvada-for-reducing-the-risk-of-acquiring-hiv.)"},{"key":"pone.0287525.ref006","volume-title":"WHO technical update on pre-exposure prophylaxis (PrEP)","author":"World Health Organization","year":"2015"},{"key":"pone.0287525.ref007","unstructured":"World Health Organization. Department of HIV\/AIDS. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: Recommendations for a public health approach \u2013 2nd edition. June 2016. 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PrEP Formulation Preferences of PrEP-Experienced African Women for HIV Prevention","volume":"88","author":"K Ngure","year":"2021","journal-title":"JAIDS Journal of Acquired Immune Deficiency Syndromes"},{"issue":"1","key":"pone.0287525.ref040","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s10461-017-1911-6","article-title":"End-users\u2019 product preference across three multipurpose prevention technology delivery forms: baseline results from young women in Kenya and South Africa","volume":"22","author":"R Weinrib","year":"2018","journal-title":"AIDS and Behavior"},{"key":"pone.0287525.ref041","doi-asserted-by":"crossref","first-page":"e25298","DOI":"10.1002\/jia2.25298","article-title":"HIV pre\u2010exposure prophylaxis for adolescent girls and young women in Africa: from efficacy trials to delivery","volume":"22","author":"CL Celum","year":"2019","journal-title":"Journal of the International AIDS Society"},{"key":"pone.0287525.ref042","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1097\/QAI.0000000000001548","article-title":"Context matters: PrEP adherence is associated with sexual behavior among HIV serodiscordant couples in East Africa","volume":"76","author":"JE Haberer","year":"2017","journal-title":"J Acquir Immune Defic Syndr"},{"key":"pone.0287525.ref043","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1089\/apc.2020.0037","article-title":"High awareness, yet low uptake, of pre-exposure prophylaxis among adolescent girls and young women within family planning clinics in Kenya","volume":"34","author":"PK Kohler","year":"2020","journal-title":"AIDS Patient Care STDs"},{"key":"pone.0287525.ref044","article-title":"Does providing laboratory confirmed STI results impact uptake of HIV pre-exposure prophylaxis (PrEP) uptake among Kenyan adolescents girls and young women? 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