Abstract: HIV Pre-Exposure Prophylaxis (PrEP) Use and Its Effects on the Sexual Health of HIV-Negative Adolescent Girls and Young Women Who Engage in Transactional Sex: A Qualitative Study (Society for Social Work and Research 28th Annual Conference - Recentering & Democratizing Knowledge: The Next 30 Years of Social Work Science)
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563P HIV Pre-Exposure Prophylaxis (PrEP) Use and Its Effects on the Sexual Health of HIV-Negative Adolescent Girls and Young Women Who Engage in Transactional Sex: A Qualitative Study

Schedule:
Sunday, January 14, 2024
Marquis BR Salon 6, ML 2 (Marriott Marquis Washington DC)
* noted as presenting author
Simon Mwima, MA, MPH, PhD Student, University of Illinois at Urbana-Champaign, Urbana, IL
Jennifer Mann Evans, MSW, Graduate Research Assistant, University of Illinois at Urbana-Champaign, Urbana, IL
Edson Chipalo, PhD, Assistant Professor, Lewis University, Romeoville, IL
Eusebius Small, PhD, Associate Professor, University of Texas at Arlington, Arlington, TX
Bosco Mukubba, Regional Manager, Alliance of Women Advocating for Change (AWAC) Uganda
Agnes Nzomene Kahouo Foda, MSW, PhD Student, University of South Carolina, Columbia, SC
Rachel Abunyo, Program Officer, Uganda Red Cross Society
Background: Pre-exposure prophylaxis (PrEP) is effective in preventing HIV infection. This study sought to explore how PrEP use impacts sexual health of Adolescent Girls and Young Women (AGYW) who use drugs and engage in transactional sex.

Methods: We conducted in-depth semi-structured intervews with 28 (aged 15-25) AGYW who reported recent use of illicit drugs and engaged in transactional sex, and had been enrolled on PrEP for <03 months. They were recruited through urban HIV clinic in Kampala between April 2018 and May 2019. We explored participants experiences on the impact of PrEP on their sexual health using content analysis. Interviews were recorded in English, transcribed verbatim, analyzed, and coded thematically using directed content analysis approach to identify key categories, commonalities, and differences across participants.

Results: Themes discovered that were associated with positive effects include: Greater sexual satisfaction (e.g., PrEP users reported having meaningful intimacy), Increased utilization of other sexual health services (e.g., routine STI and HIV testing), PrEP viewed as empowering and beneficial (e.g., AGYW do not have to rely on their sexual partners for protection during sexual intercourse). Although they viewed PrEP as beneficial, PrEP use also had negative effects which included social effects (e.g., PrEP use was associated with HIV infection and PrEP stigma), Reduced perceived HIV risk (e.g., Users reported increased condomless sex following PrEP initiation). Contextual factors attributed to their negative experiences include desire to make more money since condomless sex was reported to attract high prices form the client, limited PrEP knowledge among community members, and use of alcohol/drugs that compromised their judgment during sexual encounters.

Conclusion: We highlight the need for comprehensive community awareness campaigns about PrEP targeting key stakeholders, opportunities for harm reduction and fostering sexual health among AGYW using or those considering initiating PrEP.

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