“I just thought I was lucky to be protected from HIV:” Qualitative evaluation of barriers and facilitators of pre-exposure prophylaxis use for adolescent girls and young women at higher risk of HIV acquisition in Lilongwe, Malawi

Mallory Michalak; Odala Sande; Sam Phiri; Hannock Tweya; Geldert Chiwaya; Joseph Chintedza; Beatrice Matanje; Christine Kiruthu-Kamamia; Jacqueline Huwa; Jane Chiwoko; Tom Chaweza; Rose Nyirenda; Thokozani Kalua; Andreas Jahn; Alinafe Mbewe; Alice Maida; Evelyn Kim; Wezi Msungama; Fatima Zulu; Mtemwa Nyangulu; Sarah Shaw; Victor Singano; Newton Kalata; Alinune Kabaghe; Pragna Patel

doi:10.1371/journal.pone.0332643

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Open Access

Peer-reviewed

Research Article

“I just thought I was lucky to be protected from HIV:” Qualitative evaluation of barriers and facilitators of pre-exposure prophylaxis use for adolescent girls and young women at higher risk of HIV acquisition in Lilongwe, Malawi

Mallory Michalak ,

Roles Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Software, Writing – original draft, Writing – review & editing

* E-mail: mallory.michalak@gmail.com

Affiliation United States Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Atlanta, Georgia, United States of America

https://orcid.org/0000-0002-4993-8871

⨯
Odala Sande,

Roles Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Software, Writing – review & editing

Affiliation United States Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Lilongwe, Malawi
⨯
Sam Phiri,

Roles Conceptualization, Methodology, Project administration, Writing – review & editing

Affiliation United States Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Lilongwe, Malawi

https://orcid.org/0000-0002-9372-212X

⨯
Hannock Tweya,

Roles Conceptualization, Formal analysis, Investigation, Methodology, Project administration, Writing – review & editing

Affiliation United States Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Lilongwe, Malawi
⨯
Geldert Chiwaya,

Roles Conceptualization, Data curation, Investigation, Methodology, Writing – review & editing

Affiliation United States Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Lilongwe, Malawi
⨯
Joseph Chintedza,

Roles Conceptualization, Data curation, Investigation, Project administration, Writing – review & editing

Affiliation United States Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Lilongwe, Malawi
⨯
Beatrice Matanje,

Roles Conceptualization, Investigation, Methodology, Project administration, Writing – review & editing

Affiliation United States Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Lilongwe, Malawi
⨯
Christine Kiruthu-Kamamia,

Roles Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Supervision, Writing – original draft, Writing – review & editing

Affiliation United States Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Lilongwe, Malawi
⨯
Jacqueline Huwa,

Roles Conceptualization, Formal analysis, Supervision, Writing – original draft, Writing – review & editing

Affiliation United States Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Lilongwe, Malawi

https://orcid.org/0000-0001-8786-2487

⨯
Jane Chiwoko,

Roles Conceptualization, Data curation, Investigation, Project administration, Writing – review & editing

Affiliation United States Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Lilongwe, Malawi
⨯
Tom Chaweza,

Roles Conceptualization, Data curation, Investigation, Writing – review & editing

Affiliation United States Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Lilongwe, Malawi
⨯
Rose Nyirenda,

Roles Conceptualization, Formal analysis, Investigation, Methodology, Supervision, Writing – review & editing

Affiliation Lighthouse Trust, Lilongwe, Malawi
⨯
Thokozani Kalua,

Roles Conceptualization, Investigation, Methodology, Writing – review & editing

Affiliation United States Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Lilongwe, Malawi
⨯
Andreas Jahn,

Roles Conceptualization, Formal analysis, Investigation, Supervision, Writing – review & editing

Affiliation Lighthouse Trust, Lilongwe, Malawi
⨯
Alinafe Mbewe,

Roles Conceptualization, Investigation, Supervision, Writing – review & editing

Affiliation Lighthouse Trust, Lilongwe, Malawi
⨯
Alice Maida,

Roles Conceptualization, Methodology, Project administration, Supervision, Writing – review & editing

Affiliation Ministry of Health, Lilongwe, Malawi
⨯
Evelyn Kim,

Roles Conceptualization, Investigation, Supervision, Writing – original draft, Writing – review & editing

Affiliation United States Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Atlanta, Georgia, United States of America
⨯
Wezi Msungama,

Roles Conceptualization, Supervision, Writing – review & editing

Affiliation Ministry of Health, Lilongwe, Malawi
⨯
Fatima Zulu,

Roles Conceptualization, Supervision, Writing – review & editing

Affiliation Ministry of Health, Lilongwe, Malawi
⨯
Mtemwa Nyangulu,

Roles Conceptualization, Supervision, Writing – review & editing

Affiliation Ministry of Health, Lilongwe, Malawi
⨯
Sarah Shaw,

Roles Conceptualization, Formal analysis, Investigation, Methodology, Supervision, Writing – original draft, Writing – review & editing

Affiliation RWD Consulting, LLC, Seattle, Washington, United States of America

https://orcid.org/0000-0002-3517-0881

⨯
Victor Singano,

Roles Conceptualization, Supervision, Writing – review & editing

Affiliation Ministry of Health, Lilongwe, Malawi

https://orcid.org/0000-0002-2671-7291

⨯
Newton Kalata,

Roles Formal analysis, Methodology, Writing – original draft, Writing – review & editing

Affiliation Ministry of Health, Lilongwe, Malawi
⨯
Alinune Kabaghe,

Roles Conceptualization, Methodology, Supervision, Writing – review & editing

Affiliation Ministry of Health, Lilongwe, Malawi
⨯
[ ... ],
Pragna Patel

Roles Conceptualization, Methodology, Supervision, Writing – original draft, Writing – review & editing

Affiliation United States Centers for Disease Control and Prevention, Division of Global HIV and Tuberculosis, Atlanta, Georgia, United States of America
⨯
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“I just thought I was lucky to be protected from HIV:” Qualitative evaluation of barriers and facilitators of pre-exposure prophylaxis use for adolescent girls and young women at higher risk of HIV acquisition in Lilongwe, Malawi

Mallory Michalak,
Odala Sande,
Sam Phiri,
Hannock Tweya,
Geldert Chiwaya,
Joseph Chintedza,
Beatrice Matanje,
Christine Kiruthu-Kamamia,
Jacqueline Huwa,
Jane Chiwoko

Published: October 27, 2025
https://doi.org/10.1371/journal.pone.0332643

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