Effective strategies to support PrEP adherence among adolescent girls and young women (AGYW) are needed. We examined PrEP use disclosure and its effect on adherence among 200 AGYW ages 16–25 initiating PrEP in South Africa to help inform these strategies. We estimated the relative prevalence of high adherence (intracellular tenofovir-diphosphate concentration ≥ 700 fmol/punch) 3- and 6-months after PrEP initiation among those who disclosed vs. did not disclose their PrEP use, both overall and by age. Most AGYW disclosed to a parent (58%), partner (58%), or friend (81%) by month 6. We did not observe a strong effect of disclosure on adherence overall; however, among younger AGYW (≤ 18 years), those who disclosed to a parent were 6.8 times as likely to have high adherence at month 6 than those who did not (95% CI 1.02, 45.56). More work is needed to understand parents’ roles as allies and identify ways peers and partners can motivate PrEP use for AGYW.

需要有效的策略来支持少女和年轻女性 (AGYW) 坚持 PrEP。我们研究了 PrEP 使用披露及其对南非 200 名 16-25 岁 AGYW 开始 PrEP 依从性的影响，以帮助为这些策略提供信息。我们估计了公开与未公开其 PrEP 使用情况的人群在 PrEP 开始后 3 个月和 6 个月的高依从性（细胞内替诺福韦二磷酸盐浓度≥ 700 fmol/孔）的相对患病率，包括总体情况和年龄。大多数 AGYW 在第 6 个月之前向父母 (58%)、伴侣 (58%) 或朋友 (81%) 披露。我们没有观察到披露对总体依从性的强烈影响；然而，在较年轻的 AGYW（≤ 18 岁）中，那些向父母透露的人在第 6 个月时的依从性是那些不向父母透露的人的 6.8 倍（95% CI 1.02，45.56）。需要做更多的工作来了解父母作为盟友的角色，并确定同伴和合作伙伴可以激励 AGYW 使用 PrEP 的方式。