AUTHOR=Chen-Charles Jenny , Bekker Linda-Gail , Jochim Janina , Wittesaele Camille , Cluver Lucie , Toska Elona 

TITLE=Missed HIV prevention opportunities: the PrEP cascade among pregnant or parenting adolescent girls and young women in South Africa

JOURNAL=Frontiers in Reproductive Health

VOLUME=Volume 7 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/reproductive-health/articles/10.3389/frph.2025.1648786

DOI=10.3389/frph.2025.1648786

ISSN=2673-3153

ABSTRACT=IntroductionPregnant or parenting adolescent girls and young women (PPYW) are at greater risk of sexual exposure to HIV than their peers, yet tailored HIV prevention efforts for PPYW remain limited.MethodsWe analysed cross-sectional data (2020–2023) from a sample of PPYW (median age 21.5, IQR = 20.3–22.5) in the Eastern Cape, South Africa.ResultsApproximately 88% of PPYW who were HIV-negative (n = 646) had a HIV test in the last few years. Of these—58% knew about PrEP (n = 328). Of those who knew about PrEP, 31% had ever been offered PrEP (n = 100; 15% of HIV-negative PPYW), and 62% of those who were offered PrEP had ever taken PrEP (n = 62; 10% of HIV-negative PPYW). Compared to PPYW who have not had a HIV test in the last few years, PPYW who had accessed HIV testing were more likely to be aware of PrEP (aOR = 2.39, 95% CI:1.44–3.97, p = 0.001), have been offered PrEP (aOR = 2.96, 95% CI:1.16–7.55, p = 0.023), and taken PrEP (aOR = 4.57, 95% CI:1.09–19.16, p = 0.038).ConclusionsThis study highlights missed opportunities in PrEP delivery and offers recommendations to enhance PrEP awareness and uptake among PPYW. Despite high HIV testing rates in this key population, awareness of PrEP, its offer, and uptake remain low.