Exploring the role of group support models for HIV prevention among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA): a scoping review.

BACKGROUND: Adolescent girls and young women (AGYW) remain disproportionately affected by HIV, particularly in sub-Saharan Africa (SSA), where most AGYW living with HIV reside. Although group-based support interventions have been introduced to improve HIV prevention outcomes, evidence on how these models are structured and their effectiveness for AGYW remains limited. This scoping review mapped and synthesised evidence on group support interventions for HIV prevention among AGYW in SSA, with a focus on pre-exposure prophylaxis (PrEP) uptake, adherence, and retention in care.

METHODS: A scoping review was conducted between September and November 2024 following established methodological guidance. Group support models were defined as structured or semi-structured interventions that bring AGYW together to provide peer support, HIV and sexual and reproductive health education, psychosocial support, and skills-building to improve HIV prevention outcomes. Peer-reviewed qualitative, quantitative, and mixed-methods studies were searched across four databases using keywords. Grey literature was excluded. Data were charted and analysed thematically to map and synthesize evidence on group support interventions.

RESULTS: The initial search yielded 1,901 results after 62 duplicates were removed. 40 papers were eligible. Following title/abstract and full-text screening, 11 studies met the inclusion criteria. Full-text articles were excluded because they did not meet the target population criteria (n = 5), lacked focus on group support models (n = 12), were irrelevant to study outcomes (n = 10), or were not behavioural/health-related studies (n = 2). Group-based HIV prevention models commonly included peer-led support, HIV and sexual and reproductive health education, psychosocial support, mentorship or buddy systems, communication and negotiation skills-building, and PrEP adherence discussions. Across studies, these interventions were reportedly associated with improved HIV prevention knowledge, increased PrEP uptake and early adherence, stronger motivation to remain engaged in care, reduced stigma, improved social support, and greater confidence in sexual health decision-making. The findings suggest that group support models may help address social, cultural, and gender-related barriers to HIV prevention by creating supportive and empowering spaces for AGYW. However, evidence on long-term PrEP adherence, retention in care, scalability, sustainability, cost-effectiveness, and comparative effectiveness of different approaches was limited. Few studies reported objective adherence outcomes or longer-term HIV prevention impacts.