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HIV risk perception, trust and PrEP adherence among participants in an HIV prevention trial: a qualitative longitudinal study, South Africa

Chimukuche, Rujeko Samanthia; Shandu, Londiwe; Zulu, Silindile; Khanyile, Phindile; Singh, Nishanta; Gaffoor, Zakir; Kawuma, Rachel; ... Seeley, Janet; + view all (2025) HIV risk perception, trust and PrEP adherence among participants in an HIV prevention trial: a qualitative longitudinal study, South Africa. BMJ Open , 15 (4) , Article e086742. 10.1136/bmjopen-2024-086742. Green open access

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Abstract

INTRODUCTION: Ensuring the effectiveness of HIV prevention and treatment methods requires high levels of adherence. Studies have recognised the significance of trust in shaping HIV risk perception. AIM: In this qualitative analysis, our aim was to explore risk perceptions and understand how individuals assess and respond to HIV risks, as well as their uptake and adherence to oral pre-exposure prophylaxis (PrEP). SETTING: The study was based on the setting of an HIV prevention trial conducted in South Africa. METHODS: Thirty individuals, 9% of the total clinical trial participants, enrolled in the clinical trial were purposively selected and interviewed at three time points within the trial during the follow-up phase. Data analysis was conducted using the Trust, Confidence and Cooperation framework that included constructs of trust, confidence and cooperation. RESULTS: The findings show that the ongoing participation in the clinical trial played a significant role in influencing participants' decision to continue PrEP as HIV prevention. This decision was grounded in their trust that PrEP would effectively reduce their vulnerability to HIV and infection. CONCLUSION: Clear and consistent health-promoting initiatives enhance participants' self-awareness of HIV risks and promote understanding (uptake) and effectiveness of HIV prevention methods. TRIAL REGISTRATION NUMBER: NCT04066881.

Type: Article
Title: HIV risk perception, trust and PrEP adherence among participants in an HIV prevention trial: a qualitative longitudinal study, South Africa
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjopen-2024-086742
Publisher version: https://doi.org/10.1136/bmjopen-2024-086742
Language: English
Additional information: © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group
Keywords: Science & Technology, Life Sciences & Biomedicine, Medicine, General & Internal, General & Internal Medicine, HIV & AIDS, QUALITATIVE RESEARCH, Health, Public health, SYSTEMS
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10209963
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