Millicent Atujuna
Biographic Data
| ID | 129799 |
|---|---|
| NAME | Millicent Atujuna |
| GIVEN NAMES | Millicent |
| FAMILY NAME | Atujuna |
| SIGNATURE | ATUJUNA M |
| AFFILIATIONS | Desmond Tutu HIV Foundation |
| ORCID | 0000-0003-1287-2634 |
| VERIFIED | Yes |
| TOTAL WORKS | 37 |
| TOTAL CITATIONS | 7 |
| AUTHOR COUNT | 37 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2010 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 2 |
A Systematic Review of Barriers and Facilitators to the Uptake and Adherence of Injectable PrEP Among Adolescent Girls and Young Women in Sub-Saharan Africa
Motivations for Starting and Stopping PrEP
Oral PrEP effectiveness depends on consistent use during periods of potential HIV exposure, but adolescent girls and young women (AGYW) find this challenging. Data on PrEP use decision-making and alignment with risk among AGYW are limited. From 2016 to 2018, we conducted in-depth interviews with participants in HPTN 082, an open-label PrEP study in South Africa and Zimbabwe, to explore reasons for PrEP starts, stops, and restarts. Of 60 PrEP acce…
Study-to-Clinic Transition and Daily Oral PrEP Access Experiences Among Agyw in Eastern Cape, South Africa
Effects of female caregiver communication and behavior on sexual behavior of South African adolescent girls and young women post-HIV/STI intervention
Youth-friendly services was the magic
Adherence to daily oral pre-exposure prophylaxis (PrEP) for HIV prevention has been challenging for adolescent girls and young women (AGYW). As part of The Community PrEP Study (CPS), AGYW were randomised to HIV-prevention empowerment counselling (intervention) or basic medication pick-up (control). In this qualitative sub-study, we interviewed AGYW participants ( n = 39) to explore PrEP use and study experiences by study arm, and study staff ( n…
Adolescent Girls and Young Women Overcoming Adherence Challenges with Vaginal and Oral PrEP Use
Rates of HIV acquisition remain high among adolescent girls and young women (AGYW) in sub-Saharan Africa. We explored South African, Ugandan, and Zimbabwean AGYW's experiences in a crossover trial of two HIV prevention products: Daily oral pre-exposure prophylaxis pills and a monthly dapivirine vaginal ring. A subset of participants (n = 25) across all sites completed up to three serial in-depth interviews (SIDIs). The SIDIs explored barriers to …
The “Ideal Man”
Dominant gender norms among South African males promote ideals of masculinity characterized by control, emotional stoicism, and power, which can impact overall health. This study explores South African men’s perceptions of the “ideal” man, societal expectations, and how sexual identities intersect with masculinity, health-seeking behaviors, and HIV prevention. We conducted 40 interviews with men who have sex with women and men who have sex with m…
Preliminary effectiveness and implementation outcomes of the Imara-South Africa sexual health intervention on adolescent girls and young women
Family-based interventions may help reduce the risk of HIV and other sexually transmitted infections (STI) among adolescent girls and young women (AGYW) in sub-Saharan Africa but few have been tested. We examined the preliminary effectiveness and implementation outcomes of I nformed , M otivated , A ware , and R esponsible A dolescents and Adults— S outh A frica (IMARA-SA) , an evidence-based intervention for South African AGYW (15–19 years) and …
“I know why I am taking this pill”
There is limited understanding of the dynamic interplay between adolescent girl’s and young women’s (AGYW) disclosure and social support for using oral pre-exposure prophylaxis (PrEP) and adherence. Towards this, we conducted interviews with 42 AGYW enrolled in The Community PrEP Study who exhibited either high or low blood concentrations of tenofovir-diphosphate (TFV-DP) in dried blood spots. Guided by Theories of Practice, interviews and analys…
A qualitative analysis of family support for adolescent HIV care in South Africa
Compared to other age groups, South African adolescents living with HIV (ALWH) have the lowest rates of retention in HIV care and medication adherence. While previous research suggests that familial social support may improve treatment retention and adherence within this population, we know little about the influence of differential types of social support on HIV-related outcomes. Thus, the purpose of this study is to qualitatively characterize t…
It’s already in your body and it’s preventing”
ClinicalTrials.gov ( NCT02404038 ). Registered March 31, 2015-Registered
Adolescent Girls and Young Women’s Experiences with Disclosing Oral PrEP or Dapivirine Vaginal Ring Use
Effective use of oral pre-exposure prophylaxis (PrEP) has been low among adolescent girls and young women (AGYW) in Eastern and Southern Africa, partly due to stigma and opposition from key influencers. Understanding AGYW's experiences of disclosure of different PrEP modalities to key influencers may inform strategies to motivate uptake and adherence. We analyzed qualitative in-depth interviews and focus group discussions data from 119 participan…
Risk Factors Associated with HIV Acquisition in Males Participating in HIV Vaccine Efficacy Trials in South Africa
In South Africa, HIV acquisition risk has been studied less in people assigned male at birth. We studied the associations between risk behaviors, clinical features and HIV incidence amongst males in two South African HIV preventive vaccine efficacy trials. We used Cox proportional hazards models to test for associations between demographics, sexual behaviors, clinical variables and HIV acquisition among males followed in the HVTN 503 (n = 219) an…
The potential effect of pre-exposure prophylaxis (PrEP) roll-out on sexual-risk behaviour among adolescents and young people in East and southern Africa
Pre-exposure prophylaxis (PrEP) is an HIV-prevention strategy recommended for those at high-risk of infection, including adolescents and young people (AYP). We explored how PrEP roll-out could influence sexual risk behaviour among AYP in East and southern Africa. Twenty-four group discussions and 60 in-depth interviews were conducted with AYP between 13 and 24 years old, recruited from community settings in Uganda, Zimbabwe and South Africa, from…
Factors influencing adolescent girls and young women’s uptake of community-based PrEP services following home-based HIV testing in Eastern Cape, South Africa
Understanding Oral Prep Interest Among South African Adolescents
Women’s experience receiving drug feedback and adherence counseling in MTN-025/Hope - an HIV Prevention open-label trial of the Dapivirine Vaginal Ring
Disseminating Evidence-Based Interventions for Adolescent HIV Treatment and Prevention in Sub-Saharan Africa
Over two-thirds of adolescents living with HIV worldwide reside in sub-Saharan Africa (SSA). Despite widespread availability and access to evidence-based HIV prevention and treatment, dissemination has been inadequate. This commentary distinguishes between implementation and dissemination, reflecting on the unique barriers to dissemination of evidence-based programs in SSA. We present a seven-strategy blueprint developed by United States Agency f…
IPrevent
South African youth are one of the highest risk groups, globally, for HIV acquisition. Identifying prevention methods that will be acceptable and used consistently is an urgent priority. Engaging youth as co-designers is a targeted strategy to achieve the goal of developing prevention products that meet youth's needs. The iPrevent study engaged male and female youth, aged 18-24 years, in Cape Town, South Africa, to co-design critical aspects of t…
An individually randomized controlled trial of a mother-daughter HIV/STI prevention program for adolescent girls and young women in South Africa
ClinicalTrials.gov Number NCT04758390 , accepted 02/16/2021
Mental health outcomes of a pilot 2-arm randomized controlled trial of a HIV-prevention program for South African adolescent girls and young women and their female caregivers
ClinicalTrials.gov Number NCT04758390 , accepted 17/02/2021
The Role of Families in Adolescent and Young Adults’ PrEP Use
Perceptions matter
Uptake of contraceptive implants has declined in South Africa since their introduction in 2014, with side effects and inadequate health provider training cited as primary contributors underlying a poor community perception of implants. In this paper we explore a theme that emerged unexpectedly during analysis of our research in Cape Town that may be an additional factor in this decline: narratives of women being assaulted by robbers who physicall…
Exploring Perceived Barriers and Facilitators of PrEP Uptake among Young People in Uganda, Zimbabwe, and South Africa
Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy. Few studies have explored adolescents and young people’s perspectives toward PrEP. We conducted 24 group discussions and 60 in-depth interviews with males and females aged 13–24 years in Uganda, Zimbabwe, and South Africa between September 2018 and February 2019. We used the framework approach to generate themes and key concepts for analysis following the social ecological m…
The influence of HIV‐related stigma on PrEP disclosure and adherence among adolescent girls and young women in HPTN 082
The “Ideal Man”
Dominant gender norms among South African males promote ideals of masculinity characterized by control, emotional stoicism, and power, which can impact overall health. This study explores South African men’s perceptions of the “ideal” man, societal expectations, and how sexual identities intersect with masculinity, health-seeking behaviors, and HIV prevention. We conducted 40 interviews with men who have sex with women and men who have sex with m…
Exploring Perceived Barriers and Facilitators of PrEP Uptake among Young People in Uganda, Zimbabwe, and South Africa
Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy. Few studies have explored adolescents and young people’s perspectives toward PrEP. We conducted 24 group discussions and 60 in-depth interviews with males and females aged 13–24 years in Uganda, Zimbabwe, and South Africa between September 2018 and February 2019. We used the framework approach to generate themes and key concepts for analysis following the social ecological m…
Narrative sexual histories and perceptions of HIV risk among young women taking PrEP in southern Africa
Building resilient families
Depression contributes significantly to the global burden of disease in low- and middle-income countries. In South Africa, individuals may be at elevated risk for depression due to HIV and AIDS, violence, and poverty. For adolescents, resilience-focused prevention strategies have the potential to reduce onset of depression. Involving families in promoting adolescent mental health is developmentally appropriate, but few existing interventions take…
The impact of ART scale upon health workers
This study explores the effects of antiretroviral treatment (ART) programmes on health-care human resources in South Africa. The study included two parts, a questionnaire-based survey of 269 health workers published earlier and a qualitative study of 21 purposively selected health practitioners involved in ART scale up. Contrary to what has been presented in literature, our survey showed that health workers in ART programmes experienced higher le…
Developing family interventions for adolescent HIV prevention in South Africa
Adolescents and young people account for 40% of all new HIV infections each year, with South Africa one of the hardest hit countries, and having the largest population of people living with HIV. Although adolescent HIV prevention has been delivered through diverse modalities in South Africa, and although family-based approaches for adolescent HIV prevention have great potential for highly affected settings such as South Africa, there is a scarcit…
Experiences with HPTN 067/Adapt Study-Provided Open-Label PrEP Among Women in Cape Town
Placebo-controlled trials of pre-exposure prophylaxis (PrEP) have reported challenges with study-product uptake and use, with the greatest challenges reported in studies with young women in sub-Saharan Africa. We conducted a qualitative sub-study to explore experiences with open-label PrEP among young women in Cape Town, South Africa participating in HTPN 067/Alternative Dosing to Augment Pre-Exposure Prophylaxis Pill Taking (ADAPT). HPTN 067/ADA…
Impact of the Dapivirine Vaginal Ring on Sexual Experiences and Intimate Partnerships of Women in an HIV Prevention Clinical Trial
Why would you promote something that is less percent safer than a condom
New biomedical prevention technologies (NPTs) for HIV, including oral Pre-Exposure Prophylaxis, and vaginal and rectal microbicides and HIV vaccines in development, may contribute substantially to controlling the HIV epidemic. However, their effectiveness is contingent on product acceptability and adherence. We explored perceptions and understanding of partially effective NPTs with key populations in South African townships. From October 2013 to …
Hygiene, Blood Flow, and Vaginal Overload
Relationship Type and Use of the Vaginal Ring for HIV-1 Prevention in the MTN 020/Aspire Trial
Building resilient families
Depression contributes significantly to the global burden of disease in low- and middle-income countries. In South Africa, individuals may be at elevated risk for depression due to HIV and AIDS, violence, and poverty. For adolescents, resilience-focused prevention strategies have the potential to reduce onset of depression. Involving families in promoting adolescent mental health is developmentally appropriate, but few existing interventions take…
The influence of HIV‐related stigma on PrEP disclosure and adherence among adolescent girls and young women in HPTN 082
Community perspectives of South African adolescents’ experiences seeking treatment at local HIV clinics and how such clinics may influence engagement in the HIV treatment cascade
Despite having the largest antiretroviral treatment (ART) program in the world, only 14% of South African adolescents living with HIV (ALWH) are on ART. The purpose of this study was to identify aspects of the clinic environment that either improve or inhibit ALWH’s ability to engage in HIV care. We conducted fifty-nine semi-structured, in-depth interviews with ALWH (n = 20; 13–19 years of age), their caregivers (n = 19), and local stakeholders (…
Recreational Use of HIV Antiretroviral Medication and Implications for HIV Pre-exposure Prophylaxis and Treatment
Measuring HIV Risk Perception and Behavior
Narrative sexual histories and perceptions of HIV risk among young women taking PrEP in southern Africa
IPrevent
South African youth are one of the highest risk groups, globally, for HIV acquisition. Identifying prevention methods that will be acceptable and used consistently is an urgent priority. Engaging youth as co-designers is a targeted strategy to achieve the goal of developing prevention products that meet youth's needs. The iPrevent study engaged male and female youth, aged 18-24 years, in Cape Town, South Africa, to co-design critical aspects of t…
An individually randomized controlled trial of a mother-daughter HIV/STI prevention program for adolescent girls and young women in South Africa
ClinicalTrials.gov Number NCT04758390 , accepted 02/16/2021
Mental health outcomes of a pilot 2-arm randomized controlled trial of a HIV-prevention program for South African adolescent girls and young women and their female caregivers
ClinicalTrials.gov Number NCT04758390 , accepted 17/02/2021
The Role of Families in Adolescent and Young Adults’ PrEP Use
Perceptions matter
Uptake of contraceptive implants has declined in South Africa since their introduction in 2014, with side effects and inadequate health provider training cited as primary contributors underlying a poor community perception of implants. In this paper we explore a theme that emerged unexpectedly during analysis of our research in Cape Town that may be an additional factor in this decline: narratives of women being assaulted by robbers who physicall…
Exploring Perceived Barriers and Facilitators of PrEP Uptake among Young People in Uganda, Zimbabwe, and South Africa
Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy. Few studies have explored adolescents and young people’s perspectives toward PrEP. We conducted 24 group discussions and 60 in-depth interviews with males and females aged 13–24 years in Uganda, Zimbabwe, and South Africa between September 2018 and February 2019. We used the framework approach to generate themes and key concepts for analysis following the social ecological m…
The potential effect of pre-exposure prophylaxis (PrEP) roll-out on sexual-risk behaviour among adolescents and young people in East and southern Africa
Pre-exposure prophylaxis (PrEP) is an HIV-prevention strategy recommended for those at high-risk of infection, including adolescents and young people (AYP). We explored how PrEP roll-out could influence sexual risk behaviour among AYP in East and southern Africa. Twenty-four group discussions and 60 in-depth interviews were conducted with AYP between 13 and 24 years old, recruited from community settings in Uganda, Zimbabwe and South Africa, from…
Factors influencing adolescent girls and young women’s uptake of community-based PrEP services following home-based HIV testing in Eastern Cape, South Africa
Understanding Oral Prep Interest Among South African Adolescents
Women’s experience receiving drug feedback and adherence counseling in MTN-025/Hope - an HIV Prevention open-label trial of the Dapivirine Vaginal Ring
Disseminating Evidence-Based Interventions for Adolescent HIV Treatment and Prevention in Sub-Saharan Africa
Over two-thirds of adolescents living with HIV worldwide reside in sub-Saharan Africa (SSA). Despite widespread availability and access to evidence-based HIV prevention and treatment, dissemination has been inadequate. This commentary distinguishes between implementation and dissemination, reflecting on the unique barriers to dissemination of evidence-based programs in SSA. We present a seven-strategy blueprint developed by United States Agency f…
Preliminary effectiveness and implementation outcomes of the Imara-South Africa sexual health intervention on adolescent girls and young women
Family-based interventions may help reduce the risk of HIV and other sexually transmitted infections (STI) among adolescent girls and young women (AGYW) in sub-Saharan Africa but few have been tested. We examined the preliminary effectiveness and implementation outcomes of I nformed , M otivated , A ware , and R esponsible A dolescents and Adults— S outh A frica (IMARA-SA) , an evidence-based intervention for South African AGYW (15–19 years) and …
Medicine (32 works) · HIV/AIDS Research and Interventions (31 works) · Adolescent Sexual and Reproductive Health (27 works) · Family medicine (22 works) · Psychology (21 works) · Nursing (20 works) · Environmental health (17 works) · Human immunodeficiency virus (HIV (17 works) · Public health (17 works) · Health psychology (15 works)