Editorial: The prevention of HIV among adolescent girls and young women: leaving no one behind
Year: 2026
Type: editorial
Abstract: In 2024, about 4,000 adolescent girls and young women (AGYW) aged 15 to 24 years acquired HIV each week, and roughly 3,300 of those infections occurred in sub-Saharan Africa (1). We proposed this Research Topic because that figure has not fallen in step with the tools now on offer. Oral PrEP has been recommended for nearly a decade, HIV self-testing is widely approved, and WHO added twice-yearly injectable lenacapavir to its prevention guidance in 2025 (2). We invited work that asked who is still being missed, and why. The nine articles cover eight countries and include one global analysis. Read together, they suggest that the difficulty lies less with the products than with the distance between a method being available and a young woman being able to keep using it for as long as she needs to. surveyed school-going adolescent girls in northwestern Botswana, most of whom had not had sex. Some were unsure about correct condom use or held misconceptions about HIV. Girls who felt confident discussing condoms and refusing condomless sex were more likely to believe they could insist on condom use, which argues for sexuality education that begins before sexual debut and gives girls room to practise these conversations. Among sexually experienced students in Fuzhou, China, Yang et al. found that stronger family functioning was associated with more favourable attitudes towards HIV testing and more information-seeking, with selfmonitoring explaining part of that association. The sample was not designed around young women, but the findings bear on how caregivers might support daughters. Family-based approaches should protect young people's privacy and recognise that not every home is safe.The widest gap these studies expose lies between willingness and sustained use. In an informal settlement in Kampala, Segawa et al. found that young people rated HIV self-testing highly, yet far fewer had used a kit; cost, patchy availability, doubts about the result, and the opinions of peers and family all stood in the way. Moyo et al. report that 81.1% of eligible participants in Namibia's DREAMS programme started oral PrEP. What struck us was who did not. Young women with recent sexually transmitted infections, multiple or concurrent partners, or partners of unknown HIV status were less likely to initiate, as were those in some smaller towns. The pattern calls for locally designed counselling and service delivery, not national messaging alone.Heffron et al. evaluated PrEP delivered through postabortion care in Kenya, where most clients were in their twenties. Just over half received any PrEP information, and persistence among those who started was low. Clinics randomised to make scheduled phone calls retained significantly more women at one month, though the difference in refills, the trial's primary outcome, was not statistically significant. For anyone planning integration, the harder work begins after the first visit.Choice and safety are the concern of the last two empirical studies. Kerrigan et al. found low awareness and use of PrEP among cisgender women in the Dominican Republic and the United States. Many participants nonetheless preferred a long-acting injectable to daily tablets, with preferences shaped by concerns about injections, stigma, partner violence and earlier use of injectable contraception. The population is broader than AGYW, but with lenacapavir now recommended, programmes for younger women will soon face the same questions. Wamoyi et al. show how narrow choice becomes under criminalisation. Young female sex workers in Tanzania described stigma, mistreatment and fear of arrest, and leaned on peers to decide where, and whether, to seek care. For them, a better-equipped clinic offers little if attending it carries legal risk. We thank the authors, reviewers and the Frontiers editorial office. We hope readers will find in these articles a practical account of where prevention for AGYW breaks down and what it would take to strengthen it.
Source: Frontiers in Public Health
Authors: Enos Moyo, Tafadzwa Dzinamarira
Institutions: Stellenbosch University, University of Pretoria
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7224023933