Understanding user profiles for oral PrEP uptake: a qualitative study with adolescent girls, young women and men in Vulindlela, South Africa.

Abstract

HIV and Acquired Immuno Deficiency Syndrome (AIDS) have become a global public health problem. About 36.7 million people were living with HIV in 2016 and Sub-Saharan Africa accounts for 19.4 million of those living with HIV. Women account for 59% of those living with HIV in the Sub-Saharan region. While HIV affects both men and women in South Africa, 60% of new infections in the country occur among young women. New prevention methods including prevention of mother-to child-transmission (PMTCT) and voluntary medical male circumcision (VMMC) have shown tremendous promise. Yet, women, especially young women, have not maximally benefited from these interventions because they are not women-initiated. Thus, oral PrEP has the potential to reduce HIV transmission among adolescent girls and young women as it holds great promise as a female-initiated method in the prevention of HIV. Drawing on the concepts of the Health Belief Model (HBM) and the Social Ecology Model for Communication and Health Behaviour (SEMCHB) to understand user profiles for oral Pre-Exposure Prophylaxis (PrEP) among high- risk adolescent girls and young women (AGYW) aged 15 -25 years and men who are likely to benefit from the use of oral PrEP as a new Human Immuno Virus (HIV) prevention method in Vulindlela, South Africa. In this qualitative study, three focus group discussions were held with adolescent girls and young women (AGYW) aged 15- 25 years and men aged 25-35 in Vulindlela, South Africa to understand perceptions of risk among this key population. Further, in-depth interviews were held with the HIV testing and counseling counselor and the clinic nurse to understand how perceptions of health providers may influence the acceptability of oral PrEP among AGYW. Data were analysed using the constructs of the HBM and the SEMCHB. Thematic analysis was used to develop sub-themes that emerged from the data collected. Key findings in this study revealed that perception of risk was high among participants. However, perceived susceptibility and perceived severity was low. Further, there was a lack of knowledge about oral PrEP, which contributed to negative perceptions about this new HIV prevention method.