Cape Town - Sexually active female adolescents prefer long-acting injectables than the vaginal ring or pill as pre-exposure prophylaxis (PrEP) for HIV prevention.
This is according to the UChoose study conducted by the Desmond Tutu HIV Centre at the University of Cape Town (UCT). The findings were presented in a paper recently published in the Journal of International Aids Society.
UChoose was an open-label randomised crossover study over 32 weeks which aimed to evaluate the acceptability and preference for contraceptive options in healthy, HIV-uninfected, female adolescents aged 15 to 19 years in Cape Town, as a proxy for similar HIV prevention methods.
Participants were assigned to a contraceptive method for 16 weeks in the form of a bi-monthly injectable contraceptive, monthly vaginal ring or daily combined oral contraceptive (COC) and then asked to state their preference.
At 16 weeks, participants crossed over to another contraceptive method, to ensure that all participants tried the vaginal ring and additionally, either the injection or COC.
Overall, 46.1% of the 130 participants preferred an injectable biomedical HIV prevention method, due to its ease of administration and long‐lasting effects, followed by a vaginal ring (37.1%) and lastly oral PrEP (10.1%).
“While participants reported that they found all methods equally convenient, a significantly higher number of COC users expressed dissatisfaction because they struggled to remember to use the daily pill compared to injection and vaginal ring users. The most common self‐reported reasons for non‐adherence among vaginal ring users were that the ring came out, or discomfort,” lead author Dr Katherine Gill said.
Co-author of the study and deputy director of the Desmond Tutu HIV Centre professor Linda-Gail Bekker said adolescents perceived themselves as low risk for HIV infection.
“It was noteworthy that the greatest motivator for contraceptive adherence was participants’ desire to protect themselves from pregnancy. It is concerning that despite their high-risk sexual activity and South Africa’s high HIV burden, adolescents perceived themselves to be at low risk for acquiring HIV,” she said.
Cape Times