Work

Patterns of perceptions and beliefs about PrEP and their association with daily oral PrEP initiation among sexual and gender diverse adolescents in Brazil

Year: 2026

Type: article

Abstract: Perceptions and beliefs about pre-exposure prophylaxis (PrEP) for HIV are shaped by various factors and play a key role in its uptake. This study analyzed the relationship between these perceptions and PrEP initiation among adolescent men who have sex with men (AMSM) and adolescent transgender women (ATGW) in Brazil. This cross-sectional analysis used baseline data from the PrEP15-19 study, which evaluated the effectiveness of daily oral PrEP among AMSM and ATGW aged 15-19 years in three Brazilian cities from February 2019 to February 2023. Latent class analysis (LCA) was employed to identify patterns in PrEP-related perceptions and beliefs based on eight binary (agree/disagree) indicators. Logistic regression was used to estimate adjusted odds ratios (adjORs) for the association between these patterns of perceptions and beliefs and PrEP initiation. A total of 1,477 adolescents were included in the analysis, the majority of whom were AMSM (91%) and aged 18-19 years (74.5%). Most participants identified as Black or Mixed-race (72%), and 81.4% initiated PrEP within 30 days of their initial study visit. LCA revealed two distinct groups based on perceptions and beliefs about PrEP: positive (n = 1,348; 93.2%) and negative (n = 99; 6.8%). Adolescents with positive perceptions and beliefs were significantly more likely to initiate PrEP (adjOR = 1.73; 95%CI: 1.05-2.84). Most participants held positive perceptions and beliefs about PrEP, which were strongly associated with timely initiation. These findings highlight the importance of addressing individual perceptions and beliefs and providing accurate, accessible information about PrEP. Educational interventions are essential to further improve PrEP awareness and uptake among vulnerable adolescent populations.

Source: Cadernos de Saúde Pública

DOI: 10.1590/0102-311xen202725