Pre-exposure prophylaxis acceptability and use among adolescents in sub-Saharan Africa: Navigating barriers, beliefs, and decision-making
Full Text (PDF)
Evelyn Foster-Pagaebi 1 * , Chinazom Sylvia Ezeaka 2 , Success Tamunoibi Gwembe 3 , Uchechi Ekezie 4 , Solomon Nduka Enebeli 5 , Kilsi Henry Donabon 6
More Detail
1 Department of Clinical Pharmacy, Niger Delta University, Bayelsa, NIGERIA2 Department of Modern European languages, Nnamdi Azikiwe University, Awka, NIGERIA3 Department of Pharmaceutical and Medicinal Chemistry, Bayelsa Medical University, Bayelsa, NIGERIA4 Department of Emergency, Preparedness, Readiness and Response, World Health Organization, Abuja, NIGERIA5 Department of Inspection, Monitoring and Quality Assurance, Pharmacy Council of Nigeria, Bayelsa, NIGERIA6 Department of Clinical Services, Nasrum_Minallah Pharmacy Ltd., Rivers, NIGERIA* Corresponding Author

Abstract

Background: Adolescents and young people in sub-Saharan Africa (SSA) face a disproportionate share of new HIV infections, yet engagement with effective biomedical prevention remains limited among this group. This scoping review aimed to map and synthesize existing evidence on the perceived acceptability, uptake, adherence, and continuation of oral pre-exposure prophylaxis (PrEP) among sexually active adolescents in SSA.
Methods: We searched PubMed/MEDLINE, Web of Science, Google Scholar, and relevant grey literature for studies published from 2015 to 2025. Eligible studies focused on PrEP acceptability, initiation, adherence, continuation, barriers, facilitators, and decision-making among sexually active adolescents aged 10-24 years in SSA countries. This review was guided by the Joanna Briggs Institute framework and reported following PRISMA-ScR guidelines. Data analysis was performed using thematic synthesis.
Results: Twenty studies met the inclusion criteria. PrEP acceptability was consistently high, especially among adolescent girls and young women. However, uptake, adherence, and continuation were moderate to low and declined over time. Main barriers included a lack of knowledge, HIV-related stigma, fear of disclosure, and health system limitations. Facilitators included perceived HIV susceptibility, supportive social environments, community-based and peer-led delivery methods, and a growing focus on discreet, long-acting PrEP options.
Discussion: There was notable gap between high PrEP acceptance and sustained use among sexually active adolescents in SSA. Adolescents’ engagement with PrEP varied based on context and perceived risk of exposure.
Conclusion: These findings emphasize the importance of youth-friendly, stigma-free, and tailored PrEP delivery models to enhance consistent use among adolescents in SSA.

Keywords

License

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Review Article

J CONTEMP STUD EPIDEMIOL PUBLIC HEALTH, Volume 7, Issue 1, 2026, Article No: ep26019

https://doi.org/10.29333/jconseph/18616

Publication date: 27 May 2026

Article Views: 12

Article Downloads: 5

Open Access References How to cite this article