Stigma and Confidentiality Indiscretions: Intersecting Obstacles to the Delivery of Pre-Exposure Prophylaxis to Adolescent Girls and Young Women in East Zimbabwe

Despite efforts to scale-up biomedical HIV prevention technologies, such as oral pre-exposure prophylaxis (PrEP), many countries and regions of the world are far off–track in reaching global HIV prevention targets. Uptake of, and adherence to PrEP amongst adolescent girls and young women (AGYW) in sub-Saharan Africa has proved particularly challenging. Drawing on qualitative individual interviews and focus group discussions with thirty AGYW in east Zimbabwe, as well as interviews with healthcare providers, we investigate some of the root causes of this challenge, namely the social risks involved with accessing PrEP. We find that stigma and the worry of AGYW that privacy and confidentiality cannot be maintained in local health clinics and by local healthcare providers, presents a major barrier to the uptake of PrEP. We call for interventions that recognise the need to tackle the range of socio-cultural norms and social practices that interact and in synergy make engagement with PrEP an (im)possible and (un)desirable thing to do for AGYW.