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ORIGINAL RESEARCH article

Front. Reprod. Health
Sec. HIV and STIs
Volume 7 - 2025 | doi: 10.3389/frph.2025.1474067
This article is part of the Research Topic Accelerating to 2030 – Doubling Down on HIV Prevention to End HIV/AIDS as a Public Health Threat View all 7 articles

Community PrEP Delivery for Adolescent Girls and Young Women: Insights from the DREAMS PrEP Choice Study in Johannesburg, South Africa

Provisionally accepted
Nicolette Prea Naidoo Nicolette Prea Naidoo 1*Nqaba Mthimkulu Nqaba Mthimkulu 1Ngcwalisa Jama Ngcwalisa Jama 1Glory Chidumwa Glory Chidumwa 1Brison Chabalala Brison Chabalala 1Tafadza Mhakakora Tafadza Mhakakora 1Lauren Parmley Lauren Parmley 2Saiqa Mullick Saiqa Mullick 1
  • 1 Wits RHI, University of Witwatersrand, Johannesburg, South Africa
  • 2 United States Agency for International Development, South Africa, Johannesburg, South Africa

The final, formatted version of the article will be published soon.

    Introduction: Long-acting PrEP methods have the potential to significantly reduce HIV acquisition and increase uptake and effective use of PrEP among adolescent girls and young women (AGYW). We describe the implementation approach for delivering the PrEP Ring and outline provider perspectives related to community-based service delivery Methods: The DREAMS PrEP Choice Study, a mixed-methods implementation science study delivering PrEP choice to women 18 years and older was conducted in Johannesburg South Africa. We extracted quantitative enrollment data from the routine patient management system (REDCap) and collected qualitative data from four focus group discussions with providers. Quantitative data are presented descriptively whilst qualitative data were analyzed using content and thematic analysis. Results: Between October 2023 and April 2024, 657 participants were enrolled and offered PrEP choice. Most (72.1%, n=474) participants were between 18-24 years and accessed services at education and training institutions (52.1%, n=342). Sixty-eight percent (68.8%, n=451) chose oral PrEP at enrollment, 26.6% (n=175) PrEP ring, and 3.2% (n=20) selecting no method. Most participants accessed services through a mobile truck (n=365, 55.6%). There was a strong preference for nurse insertion of Ring on site (n=103, 58.9%). Site set up, privacy and access to running water, in alignment with national PrEP Ring guidelines, were reported as barriers to implementation. Conclusion: As one of the first studies to implement community-based services for PrEP choice, early results indicate feasibility to deliver with moderate uptake of PrEP by AGYW to use PrEP ring. Understanding the service delivery conditions required to offer informed choice is important for supporting national scale up.

    Keywords: hiv prevention, AGYW, PrEP, South Africa, community-based (Min 5 and Max 8)

    Received: 01 Aug 2024; Accepted: 09 Jan 2025.

    Copyright: © 2025 Naidoo, Mthimkulu, Jama, Chidumwa, Chabalala, Mhakakora, Parmley and Mullick. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Nicolette Prea Naidoo, Wits RHI, University of Witwatersrand, Johannesburg, South Africa

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.