Authors :
Mufalali Dinaless; Taonga Samwaka
Volume/Issue :
Volume 10 - 2025, Issue 9 - September
Google Scholar :
https://tinyurl.com/ymxbjbsj
Scribd :
https://tinyurl.com/4dnds8k8
DOI :
https://doi.org/10.38124/ijisrt/25sep705
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Note : Google Scholar may take 30 to 40 days to display the article.
Abstract :
HIV/AIDS remains a major health challenge for adolescent girls, particularly in sub-Saharan Africa. This study
aimed to assess the impact of the PrEP program on HIV prevention among adolescent girls in Kawama Compound,
Mufulira. A cross-sectional survey was conducted among 50 girls aged 15–19 years, using structured questionnaires and
face-to-face interviews, with stratified random sampling to ensure representation across age, education, and geographic
zones. The results showed that while 88% were aware of PrEP, only 25% had comprehensive knowledge, and among those
eligible (84%), just 50% initiated PrEP older adolescents being more likely to start. Adherence was problematic, as 38%
discontinued and only 54% of users maintained high adherence, with 72% reporting community-level stigma as a barrier.
Ultimately, only 14% achieved effective protection through sustained, high-adherence use. The study thus, concluded that,
despite high awareness, the program faced significant challenges in knowledge, uptake, and adherence, highlighting the need
for interventions targeting stigma reduction, better education, youth-friendly services, and adherence support to improve
PrEP outcomes for adolescent girls.
Keywords :
Pre-Exposure Prophylaxis, Adolescent Girls, HIV Prevention, Stigma, Adherence.
References :
- Admassu, B., Mbatha, P., & Smith, A. (2024). A scoping review of pre‑exposure prophylaxis use among adolescent girls and young women in sub‑Saharan Africa. AIDS and Behavior, 28(1), 269–277.
- Amico, K. R., Ochalla, F., Wanyenze, R. K., & Bangsberg, D. R. (2019). Adherence to daily oral pre‑exposure prophylaxis among young women in Uganda: A qualitative study. AIDS and Behavior, 23(4), 957–968.
- AVAC. (2022). Global PrEP Tracker. https://www.avac.org/global‑prp‑tracker
- Baeten, J. M., Haberer, J. E., Liu, A., & Sista, N. (2018). Pre‑exposure prophylaxis for HIV prevention: Where have we been and where are we going? Journal of Acquired Immune Deficiency Syndromes, 77(2), 125–133.
- Bekker, L. G., Rebe, K., Venter, F., Maartens, G., Moorhouse, M., Conradie, F., Wallis, C., Black, V., Harley, B., & Eakle, R. (2020). Oral pre-exposure prophylaxis uptake in South Africa: Implementation data from the first phase of scale-up. The Lancet HIV, 7(3), e181-e190.
- Browne, E. P., Onono, M., & Bukusi, E. A. (2023). Intimate partner violence and PrEP use among adolescent girls and young women in Kenya: Findings from the Tu’Washindi trial. Journal of Adolescent Health, 72(3), 185–193.
- CDC. (2022). Progress Toward UNAIDS Global HIV PrEP Targets – Fact Sheet. Centers for Disease Control and Prevention.
- Celum, C., Hosek, S., Tsholwana, M., & Delany-Moretlwe, S. (2019). PrEP uptake, adherence, and discontinuation among young women in sub-Saharan Africa: How do we define success? Journal of the International AIDS Society, 22(9), e25358.
- Centers for Disease Control and Prevention. (2024). Global PrEP initiations report: 2017–2023. U.S. Department of Health and Human Services. https://www.cdc.gov/hiv/pdf/library/reports/prp‑2024.pdf
- Chanda, M. M., Ortblad, K. F., Mwale, M., Chongo, S., Kanchele, C., Kamungoma, N., Barresi, L. G., Harling, G., Bärnighausen, T., & Oldenburg, C. E. (2023). Fostering access to PrEP among adolescent girls and young women through the DREAMS initiative in Zambia. PLoS ONE, 17(3), e0264249.
- Chibwana, L., & Banda, P. (2023). Engaging traditional leaders to promote PrEP: A case study from Eastern Province, Zambia. Global Public Health, 18(8), 1122–1135.
- Dunbar, M. S., Kripke, K., Haberer, J., Castor, D., Dalal, S., Mukoma, W., Mullick, S., Patel, S., Reed, J., & Baeten, J. (2018). Understanding and measuring uptake and coverage of oral pre-exposure prophylaxis delivery among adolescent girls and young women in sub-Saharan Africa. Sexual Health, 15(6), 513-521.
- Fonner, V. A., Dalglish, S. L., Kennedy, C. E., Baggaley, R. F., O’Reilly, K. R., Koechlin, F. M., & Grant, R. M. (2016). Effectiveness and safety of oral HIV pre‑exposure prophylaxis for all populations: A systematic review and meta‑analysis. AIDS, 30(12), 1973–1983.
- Food and Drug Administration. (2012). FDA approves first drug for reducing the risk of sexually acquired HIV infection. U.S. Department of Health and Human Services. https://www.fda.gov/news‑events/press‑announcements/fda‑approves‑first‑drug‑reducing‑risk‑sexually‑acquired‑hiv‑infection
- Glanz, K., Rimer, B. K., & Viswanath, K. (2018). Health behavior: Theory, research, and practice (5th ed.). Jossey‑Bass.
- Hakim, A., Nshuti, R., & Mtei, G. (2022). Youth‑friendly service delivery models for PrEP in Tanzania: Findings from the national HIV Impact Survey. BMC Health Services Research, 22(1), 567.
- Hosek, S., Celum, C., Wilson, C. M., Kapogiannis, B., Delany-Moretlwe, S., & Bekker, L. G. (2021). Preventing HIV among adolescents with oral PrEP: Observations and challenges in the United States and South Africa. Journal of the International AIDS Society, 24(S4), e25746.
- Lakens, D., 2022. Sample size justification. Collabra: psychology, 8(1), p.33267.
- Mavedzenge, S. N., Luecke, E., & Ross, D. A. (2020). Uptake, retention in care, and adherence to PrEP among adolescent girls and young women in sub-Saharan Africa: A systematic review and meta-analysis. AIDS and Behavior, 24(9), 2564-2575.
- Mayimbo, S., Mulenga, D., & Sitali, L. (2019). HIV infection risk awareness and sexual behaviour among young women: Observations from Mufulira, Zambia. Journal of Psychiatry and Behavioral Sciences, 2(2), 1024.
- McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Education Quarterly, 15(4), 351-377.
- McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Education Quarterly, 15(4), 351–377.
- Meek, C., Seekaew, P., Mantell, J. E., Link, C. G., Mulenga, D., & Chimba, M. (2022). Health worker perceptions of stigma towards Zambian AGYW seeking HIV services. BMC Health Services Research, 22, 1253.
- Minnis, A. M., Govender, V., & Baral, S. (2019). Adolescent girls’ uptake of PrEP in HPTN 082: A qualitative study. Journal of Adolescent Health, 64(3), 375–383.
- Mukaba, T., & Chitundu, M. (2024). Parental attitudes toward PrEP use among adolescent girls in Lusaka, Zambia. Journal of Adolescent Health, 74(1), 85–92.
- Nakku-Joloba, E., Pisarski, E. E., Wyatt, M. A., Muwonge, T. R., Asiimwe, S., Celum, C. L., Ngure, K., Ware, N. C., & Baeten, J. M. (2019). Beyond HIV prevention: Everyday life priorities and demand for PrEP among Ugandan HIV serodiscordant couples. Journal of the International AIDS Society, 22(1), e25225.
- National AIDS and STI Control Programme. (2018). Guidelines on the use of antiretroviral drugs for treatment and prevention of HIV infection in Kenya. Ministry of Health, Government of Kenya.
- Nunn, A. S., Cornwall, A., & Mugisha, F. (2019). Uptake of PrEP among high‑risk adolescent girls and young women in Kampala, Uganda. AIDS and Behavior, 23(3), 279–287.
- Nwaozuru, U., Iwelunmor, J., Ong, J. J., Salah, S., Obiezu-Umeh, C., Ezechi, O., & Tucker, J. D. (2021). Preferences for HIV testing services among young people in Nigeria. BMC Health Services Research, 21(1), 1-14.
- O'Malley, G., Barnabee, G., Mugwanya, K., Donnell, D., Ndase, P., Mugo, N., Celum, C., & Baeten, J. M. (2021). "What is this PrEP?" – Sources and accuracy of PrEP awareness among AGYW in Kenya. Journal of Acquired Immune Deficiency Syndromes, 87(3), e288-e296.
- Okoye, H.U., 2024. Intersecting social statuses, health inequities, and macro-social influences on HIV risk behaviour among adolescents in Sub-Saharan Africa: a structural determinants exploration (Doctoral dissertation, University of British Columbia).
- PEPFAR. (2022). Zambia DREAMS program: PrEP uptake evaluation report. U.S. President’s Emergency Plan for AIDS Relief. https://www.pepfar.gov/documents/organization/Zambia‑COP22‑Report.pdf
- Pettifor, A., Nguyen, N., & Celum, C. (2023). Age‑related differences in PrEP uptake among adolescent girls and young women in Zambia: Findings from the DREAMS evaluation. BMC Public Health, 23(1), 451.
- Pintye, J., Beima-Sofie, K. M., Kimemia, G., Ngure, K., Trinidad, S. B., Heffron, R. A., Baeten, J. M., & Matemo, D. (2019). "I did not want to give birth to a child who has HIV": Experiences using PrEP during pregnancy among HIV-uninfected Kenyan women in HIV-serodiscordant couples. Journal of the International AIDS Society, 22(9), e25378.
- Ramadhani, H. O., Njelekela, M., Chillo, O., Kazaura, M., & Mmbaga, B. T. (2021). Awareness and attitudes towards pre-exposure prophylaxis (PrEP) among adolescents and young adults in Tanzania. AIDS and Behavior, 25(8), 2438-2447.
- Ramadhani, H. O., Webb, E. L., Diallo, A., & Mmbaga, B. T. (2025). PrEP awareness and endorsement among adolescents and young adults in Tanzania: Insights from the 2022 DHS. Annals of Global Health, 91(1), 4.
- Simbayi, L. C., Shisana, O., & Zuma, K. (2019). Awareness and uptake of PrEP among adolescent girls in South Africa: Findings from a national survey. South African Medical Journal, 109(5), 1–4.
- Simoni, J. M., Bukusi, E. A., & Yende‑Zuma, N. (2021). Tu’Washindi: Engaging male partners to support PrEP use among adolescent girls and young women in Kenya. AIDS and Behavior, 25(6), 1899–1908.
- Smith, J., & Ndlovu, L. (2020). Stigma and PrEP uptake among adolescent girls in Eswatini. Journal of the International AIDS Society, 23(2), e25421.
- Tanzania Commission for AIDS, Zanzibar AIDS Commission, National Bureau of Statistics, et al. (2022). Tanzania HIV Impact Survey 2022. TACAIDS.
- Thigpen, M. C., Kebaabetswe, P. M., Paxton, L. A., et al. (2012). Antiretroviral pre‑exposure prophylaxis for heterosexual HIV transmission in Botswana. New England Journal of Medicine, 367(5), 423–434.
- UNAIDS. (2022). UNAIDS Data 2022. https://www.unaids.org/en/resources/documents/2022/UNAIDS_data
- UNAIDS. (2023). UNAIDS Data 2023. https://www.unaids.org/en/resources/documents/2023/UNAIDS_data
- United States Department of state, (2025). Info memo for the PEPFER implementing agencies and PEPFER coordinators. Implementation of Limited Waiver to Pause of U.S. Foreign Assistance for Life-Saving HIV Service Provision. https://www.unaids.org/sites/default/files/media_asset/US-Department-of-State-guidance-on-HIV-services-to-be-immediately-resumed-under-waiver.pdf
- Van der Straten, A., Stadler, J., & Montgomery, E. (2019). Factors influencing PrEP uptake among adolescent girls in sub‑Saharan Africa: A mixed‑methods study. AIDS and Behavior, 23(3), 716–726.
- https://www.facebook.com/znbctoday/posts/23000-hiv-cases-were-recorded-in-2024by-white-luhanga-the-new-hiv-infection-rate/1027462172819081/
- Velloza, J., Khoza, N., Scorgie, F., Chitukuta, M., Mutero, P., Mutiti, K., Mangxilana, N., Nobula, L., Bulterys, M. A., & Atujuna, M. (2020). The influence of HIV-related stigma on PrEP disclosure and adherence among adolescent girls and young women in HPTN 082: A qualitative study. Journal of the International AIDS Society, 23(3), e25463.
- Westercamp, N., et al. (2018). Barriers to PrEP adherence among adolescent girls in Africa: A systematic review. Journal of the International AIDS Society, 21(11), e25183.
- World Health Organization. (2015). Guideline on when to start antiretroviral therapy and on pre‑exposure prophylaxis for HIV. https://www.who.int/publications/i/item/9789241509565
- Wong, C.M., Munthali, T., Mangunje, F.G., Katoka, M.L., Burke, H.M., Musonda, B., Musonda, M. and Todd, C.S., 2024. Creating allies: qualitative exploration of young women’s preferences for PrEP methods and parents’ role in PrEP uptake and user support in urban and rural
- Zambia National Broadcasting Cooperation (2025). 23000 new Zambian HIV cases report, https://www.facebook.com/znbctoday/posts/23000-hiv-cases-were-recorded-in-2024by-white-luhanga-the-new-hiv-infection-rate/1027462172819081/.
HIV/AIDS remains a major health challenge for adolescent girls, particularly in sub-Saharan Africa. This study
aimed to assess the impact of the PrEP program on HIV prevention among adolescent girls in Kawama Compound,
Mufulira. A cross-sectional survey was conducted among 50 girls aged 15–19 years, using structured questionnaires and
face-to-face interviews, with stratified random sampling to ensure representation across age, education, and geographic
zones. The results showed that while 88% were aware of PrEP, only 25% had comprehensive knowledge, and among those
eligible (84%), just 50% initiated PrEP older adolescents being more likely to start. Adherence was problematic, as 38%
discontinued and only 54% of users maintained high adherence, with 72% reporting community-level stigma as a barrier.
Ultimately, only 14% achieved effective protection through sustained, high-adherence use. The study thus, concluded that,
despite high awareness, the program faced significant challenges in knowledge, uptake, and adherence, highlighting the need
for interventions targeting stigma reduction, better education, youth-friendly services, and adherence support to improve
PrEP outcomes for adolescent girls.
Keywords :
Pre-Exposure Prophylaxis, Adolescent Girls, HIV Prevention, Stigma, Adherence.