Nurse-Led Pre-Exposure Prophylaxis Delivery to Adolescent Girls and Young Women Accessing Family Planning Services: A Pilot Study in Uganda

Oral pre-exposure prophylaxis (PrEP) remains underused by adolescent girls and young women (AGYW), partly due to stigma within HIV clinics. Sexual and reproductive health (SRH) clinics, perceived as more socially acceptable than HIV clinics, have nurses who quickly identify PrEP-eligible AGYW. We piloted a nurse-led PrEP delivery model at Kawaala Health Centre IV, Kampala (December 2021-July 2022). Acceptability was defined as the proportion initiating PrEP, retention as the proportion returning for refills, and adherence self-reported as good (≤3 pills missed), fair, or poor. Time-motion observations estimated visit durations. We enrolled 59 AGYW (median age: 22 years). Retention was 83% at 1 month, 63% at 3 months, and 41% at 6 months. Good adherence was 69% at 1 month, 45% at 3 months, and 71% at 6 months. Initiation visits lasted 95 min. Nurse-led PrEP delivery in SRH clinics is acceptable and could improve uptake despite prolonged visit times.