Motivators for oral PrEP uptake and adherence in the eThekwini municipality, KwaZulu-Natal

ABSTRACT

Pre-exposure prophylaxis (PrEP) is a single daily pill that prevents a seropositive HIV status. Since 2016, South Africa has staggered PrEP roll-out, with uptake levels not reaching optimal goals. The aim of this study was to determine motivation behind PrEP initiation and adherence among South African users. A phenomenological qualitative study (n = 15) was used. Participants were purposively recruited from two primary healthcare clinics in eThekwini, KwaZulu-Natal. Thematic analysis was used to analyse the data. Three themes were identified: motivation for PrEP uptake, PrEP adherence and PrEP awareness. Initiation was influenced by healthcare professionals. Responsibility for one’s well-being, serodiscordant relationships and sexual partner’s behavioural patterns contributed toward initiation. Most were fully compliant, using reminders to negate medication forgetfulness. The internet and healthcare professionals served as information sources, however, few were aware of PrEP prior to this. Innovative ways are required to increase awareness levels and increase uptake.

KEYWORDS:

• Pre-exposure prophylaxis (PrEP)
• initiation and/or uptake
• adherence
• clinic users or clinic patients
• South Africa

Acknowledgements

Thank you to all the participants who shared their experiences. To the staff and operational managers of the primary healthcare clinics, thank you for hosting this research study and ensuring its success. To the KwaZulu-Natal Department of Health, thank you for providing consent for this study. Author contributions: All authors designed the study. JB conducted the interviews and subsequent data analysis. FH and PR provided input for the data analysis. JB compiled the first draft of the article and received guidance from FH and PR. All authors revised and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The study was funded by the Durban University of Technology as part of an ongoing study. In addition, JB was a Durban University of Technology scholarship recipient.