Exploring HIV risk perception mechanisms among youth in a test-and-treat trial in Kenya and Uganda - PubMed (original) (raw)

. 2024 May 2;4(5):e0002922.

doi: 10.1371/journal.pgph.0002922. eCollection 2024.

Jason Johnson-Peretz 2, Joi Lee 2, Monica Getahun 2, Dana Coppock-Pector 2, Irene Maeri 1, Anjeline Onyango 1, Craig R Cohen 2, Elizabeth A Bukusi 1, Jane Kabami 3, James Ayieko 1, Maya Petersen 4, Moses R Kamya 3 5, Edwin Charlebois 6, Diane Havlir 7, Carol S Camlin 2 6

Affiliations

Exploring HIV risk perception mechanisms among youth in a test-and-treat trial in Kenya and Uganda

Lawrence Owino et al. PLOS Glob Public Health. 2024.

Abstract

Understanding risk perception and risk-taking among youth can inform targeted prevention efforts. Using a health beliefs model-informed framework, we analysed 8 semi-structured, gender-specific focus group discussions with 93 youth 15-24 years old (48% male, 52% female), drawn from the SEARCH trial in rural Kenya and Uganda in 2017-2018, coinciding with the widespread introduction of PrEP. Highly connected social networks and widespread uptake of antiretrovirals shaped youth HIV risk perception. Amid conflicting information about HIV prevention methods, youth felt exposed to multiple HIV risk factors like the high prevalence of HIV, belief that people with HIV(PWH) purposefully infect others, dislike of condoms, and doubts about PrEP efficacy. Young women also reported minimal sexual autonomy in the context of economic disadvantages, the ubiquity of intergenerational and transactional sex, and peer pressure from other women to have many boyfriends. Young men likewise reported vulnerability to intergenerational sex, but also adopted a sexual conquest mentality. Comprehensive sexuality education and economic empowerment, through credible and trusted sources, may moderate risk-taking. Messaging should leverage youth's social networks to spread fact-based, gender- and age-appropriate information. PrEP should be offered alongside other reproductive health services to address both pregnancy concerns and reduce HIV risk.

Copyright: © 2024 Owino et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Conflict of interest statement

The authors have declared that no competing interests exist.

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