Educators' perceptions on the benefits and barriers of oral PrEP uptake among adolescent girls and young women in Vulindlela, KwaZulu-Natal

Abstract

Oral PrEP promotion is a key aspect of combination prevention efforts to increase opportunities for HIV prevention among adolescent girls and young women (AGYW) who are at higher risk of infection. Research suggests that communication efforts often adopt an individualistic decision-making approach that is devoid of the multiple influences that impact young women’s HIV preventative choices. Schools and educators are increasingly being identified as key role players and influencers of decision making among young women. The promotion of PrEP uptake among AGYW of school going age, thus requires an exploration of perceptions of educators about the related benefits and barriers to PrEP uptake among school girls. A qualitative study using a purposive sampling method was used to sample 6 high schools in Vulindlela, a district with the highest HIV incidents among AGYW in KwaZulu-Natal. Semi-structured interviews were conducted with a total of twelve Life Orientation educators and senior staff members from the 6 selected high schools. The data was transcribed and analysed thematically using the culture-centred approach. The findings suggested that educators acknowledged the benefits of PrEP in curbing HIV infection rates among young women. However, these benefits were clouded by barriers and concerns around minimal, or poor condom use as a result of oral PrEP use which could promote promiscuity and minimalise efficacy. These findings highlight the need for more contextual community-driven communication strategies around PrEP, and emphasise the value of a community-centred approach that promotes dialogue among key role players, like educators, to further enhance PrEP communication.