Antiretroviral therapy based HIV prevention targeting young women who sell sex: A mixed method approach to understand the implementation of PrEP in a rural area of KwaZulu-Natal, South Africa

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dc.contributor.authorNatsayi Chimbindi
dc.contributor.authorNondumiso Mthiyane
dc.contributor.authorThembelihle Zuma
dc.contributor.authorKathy Baisley
dc.contributor.authorDeenan Pillay
dc.contributor.authorNuala McGrath
dc.contributor.authorGuy Harling
dc.contributor.authorLorraine Sherr
dc.contributor.authorIsolde Birdthistle
dc.contributor.authorSian Floyd
dc.contributor.authorJaco Dreyer
dc.contributor.authorSarah Nakasone
dc.contributor.authorJanet Seeley
dc.contributor.authorMaryam Shahmanesh§
dc.date.accessioned2024-03-18T09:21:17Z
dc.date.available2024-03-18T09:21:17Z
dc.date.issued2022-02
dc.description.abstractPre-Exposure Prophylaxis (PrEP) is a potential game-changer for HIV. We used PrEP introduction for Young Women Who Sell Sex (YWSS) in a rural South Africa district to understand community norms and PrEP coverage in YWSS. Between 2017 and 2018, we measured awareness and uptake of PrEP in a representative cohort of 2184 Adolescent Girls and Young Women (AGYW) aged 13-22. We conducted group discussions with young people and community members (19); key informant interviews (9), in-depth interviews with 15-24 year-olds (58) and providers (33). Interviews were analysed using thematic analysis. PrEP awareness increased from 2% to 9%. Among 965 AGYW sexually-active by 2018, 13.4% (95%CI: 11.4%-15.7%) reported transactional sex and 10.6% (95%CI: 8.85-12.7%) sex for money. Of the 194 YWSS, 21 were aware of PrEP, but none had used it. Youth were enthusiastic about PrEP as tool for HIV prevention; whilst older community members were cautious about a technology they had limited experience with but could benefit select groups. Teachers and healthcare providers were concerned that PrEP would lower personal responsibility for sexual health. In conclusion, the narrow and limited introduction of PrEP to YWSS reduced the accessibility and reach. Introducing PrEP as part of sexual healthcare may improve demand and access for YWSS.
dc.description.librarianPM2023
dc.facultyFaculty of Health Sciences
dc.identifier.urihttps://hdl.handle.net/10539/38082
dc.language.isoen
dc.schoolPublic Health
dc.subjectAccess framework; HIV prevention interventions; acceptability; adolescents; female-sex workers; pre-exposure prophylaxis (PrEP); young women who sell sex.
dc.titleAntiretroviral therapy based HIV prevention targeting young women who sell sex: A mixed method approach to understand the implementation of PrEP in a rural area of KwaZulu-Natal, South Africa
dc.typeArticle
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