Reasons for declining PrEP among AGYW with high behavioral HIV risk who declined PrEP (n = 111). Behavioral HIV risk was defined using the Balkus et al. HIV risk scoring: age <25 = 1, married = 2, any alcohol = 1, partner provides financial support = 1, and partner has other partners: yes = 2 and do not know = 2. Scores of ≥5 correspond to 5–15 incident HIV cases per 100 person-years in cohorts of African women; risk scores of ≤4 correspond to <5 incident HIV cases per 100 person-years, (high HIV risk: HIV risk score ≥5). AGYW, adolescent girls and young women; PrEP, pre-exposure prophylaxis.