Tailoring Communication to Increase the Promotion of Oral PrEP: A Culture-Centred Approach

Abstract In Sub-Saharan Africa, human immunodeficiency virus (HIV) incidence rates remain disproportionately high among adolescent girls and young women (AGYW), who are five to seven times more likely to contract HIV than their male peers. Following the 2015 World Health Organization (WHO) Guideline on When to Start Antiretroviral Therapy and on Pre-Exposure Prophylaxis (PrEP) for HIV, the South African Department of Health (DoH) released the National Policy on HIV PrEP and Test and Treat (T&T) in June 2016. At the time of writing, several demonstration projects were underway to assess the feasibility of oral PrEP for AGYW in South Africa, with extensive access for sex workers and limited access for AGYW. It is within this context that the article explores the current perceptions of oral PrEP utilising the data from two previous studies conducted in three high HIV burden districts in KwaZulu-Natal (KZN), South Africa. Through an analysis of the current perceptions of oral PrEP, the article prioritises the cultural communication imperative to promote inclusivity and acceptability of biomedical innovations. The article argues that communication about oral PrEP is embedded in cultural discourses that must be discussed, critiqued and incorporated into a new framework for combination HIV prevention.