Decoding HIV pre‑exposure prophylaxis through youth experiences of misinformation, stigma and communication
1
Nursing Sciences, Cape Peninsula University of Technology, Bellville, South Africa
2
Implementation, Knowledge Translation Foundation, Rondebosch, South Africa
3
Nursing and Midwifery, Stellenbosch University, Parow, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A3347
ABSTRACT
INTRODUCTION:
Globally, the youth is at a higher risk of acquiring HIV, with 40.8 million people living with the virus and 1.3 million new infections were reported in 2024.1,2 Sub-Saharan Africa accounts for a substantial proportion of the global burden and approximately half of new infections.2 South Africa’s high HIV prevalence persists despite increased PrEP coverage, with poor continuation and adherence.3 Despite PrEP’s effectiveness, uptake and utilisation among adolescent girls and young women in sub-Saharan Africa remain suboptimal.4 This study explored youth experiences using PrEP to understand how misinformation, stigma and communication gaps influence PrEP use.
METHODS:
A qualitative exploratory, descriptive, and contextual design was used. Seven youth aged 18 to 29 using HIV pre exposure prophylaxis were interviewed in two Tygerberg sub district clinics between December 2022 and August 2023. Purposive and professional referral sampling were applied. Interviews were audio recorded, transcribed, and analysed thematically, with consensus reached with an independent coder.
RESULTS:
The youth reported that community members misunderstood HIV pre exposure prophylaxis as antiretroviral therapy and associated its use with being HIV positive or promiscuous. The pill container and norms that discouraged clinic attendance reinforced stigma. Clinic communication challenges, including rushed counselling, unclear information, and limited guidance on adherence and side effects, contributed to missed doses or stopping the medication. Participants described difficulties with side effects, pill size, and maintaining daily routines, and used coping strategies such as adjusting medication timing, setting reminders, and informing trusted individuals.
CONCLUSIONS:
Evidence indicates that age‑appropriate counselling and supportive provider interactions promote sustained use of HIV pre‑exposure prophylaxis, while stigma and misinformation undermine adherence.4,5 Improving uptake requires addressing misinformation, reducing stigma, and strengthening provider‑community communication. Community awareness that promotes HIV pre‑exposure prophylaxis and reinforces evidence‑based messages is essential in an increasingly complex misinformation environment.5,6
Globally, the youth is at a higher risk of acquiring HIV, with 40.8 million people living with the virus and 1.3 million new infections were reported in 2024.1,2 Sub-Saharan Africa accounts for a substantial proportion of the global burden and approximately half of new infections.2 South Africa’s high HIV prevalence persists despite increased PrEP coverage, with poor continuation and adherence.3 Despite PrEP’s effectiveness, uptake and utilisation among adolescent girls and young women in sub-Saharan Africa remain suboptimal.4 This study explored youth experiences using PrEP to understand how misinformation, stigma and communication gaps influence PrEP use.
METHODS:
A qualitative exploratory, descriptive, and contextual design was used. Seven youth aged 18 to 29 using HIV pre exposure prophylaxis were interviewed in two Tygerberg sub district clinics between December 2022 and August 2023. Purposive and professional referral sampling were applied. Interviews were audio recorded, transcribed, and analysed thematically, with consensus reached with an independent coder.
RESULTS:
The youth reported that community members misunderstood HIV pre exposure prophylaxis as antiretroviral therapy and associated its use with being HIV positive or promiscuous. The pill container and norms that discouraged clinic attendance reinforced stigma. Clinic communication challenges, including rushed counselling, unclear information, and limited guidance on adherence and side effects, contributed to missed doses or stopping the medication. Participants described difficulties with side effects, pill size, and maintaining daily routines, and used coping strategies such as adjusting medication timing, setting reminders, and informing trusted individuals.
CONCLUSIONS:
Evidence indicates that age‑appropriate counselling and supportive provider interactions promote sustained use of HIV pre‑exposure prophylaxis, while stigma and misinformation undermine adherence.4,5 Improving uptake requires addressing misinformation, reducing stigma, and strengthening provider‑community communication. Community awareness that promotes HIV pre‑exposure prophylaxis and reinforces evidence‑based messages is essential in an increasingly complex misinformation environment.5,6
| eISSN: | 2654-1459 |
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