Wits RHI, University of the Witwatersrand, Johannesburg, South Africa.
PLoS One. 2024 Jan 2;19(1):e0296341. doi: 10.1371/journal.pone.0296341. eCollection 2024.
INTRODUCTION: Oral pre-exposure prophylaxis (PrEP) is an effective HIV prevention method; however, males over 15 years face challenges with its effective use. Long-acting prevention products could address barriers to effective PrEP use. This study aimed to estimate the potential uptake of a mono-PrEP implant and the factors influencing uptake among males in South Africa. The study also examined messaging and demand creation tactics that males perceive will improve HIV prevention uptake. METHODS: We conducted a mixed methods study comprising participatory workshops and a self-administered survey among 142 PrEP-eligible males (18-40 years) in three provinces (Gauteng, Eastern Cape, and Kwa-Zulu Natal) in South Africa from July to November 2022. Logistic regression was used to assess the relationship between the potential uptake of a hypothetical, non-biodegradable mono-PrEP implant and socioeconomic and behavioural factors. Workshop data were analysed using content analysis. RESULTS: The top three HIV prevention products that males would consider using were the monthly pill (74.6%), the mono-PrEP implant (62.7%), and event-driven oral PrEP (59.2%). If one prevention option was available, 31.7% of participants stated that they would use the monthly oral pill, 28.2% would use the six-monthly injection, and 19.7% the mono-PrEP implant. Four key themes were noted as influential to potential mono-PrEP uptake: "Health Over Everything", "Mono-PrEP Implant Concerns", "Potential Disclosure of Mono-PrEP Use", and "Information Distribution Channels". Participants preferred social and mainstream media as information distribution channels to receive information on HIV prevention services, including the mono-PrEP implant. CONCLUSION: In this study among predominantly heterosexual men in South Africa, there was interest in long-acting HIV prevention methods but concerns about the mono-PrEP implant. A comprehensive and participatory introduction will be needed for the implant, to improve acceptability and address potential concerns. Demand-creation strategies utilising social media and health campaigns should be considered to engage and reach males.
引言：口服暴露前预防（PrEP）是一种有效的艾滋病预防方法；然而，15 岁以上的男性在有效使用 PrEP 方面面临挑战。长效预防产品可以解决有效使用 PrEP 的障碍。本研究旨在估计单剂 PrEP 植入物在南非男性中的潜在使用率以及影响其使用率的因素。该研究还探讨了男性认为将提高艾滋病预防使用率的信息传递和需求创造策略。
方法：我们在 2022 年 7 月至 11 月期间在南非三个省份（豪登省、东开普省和夸祖鲁-纳塔尔省）进行了一项混合方法研究，包括参与式研讨会和对 142 名符合 PrEP 条件的男性（18-40 岁）进行的自我管理调查。逻辑回归用于评估假设的不可生物降解的单剂 PrEP 植入物的潜在使用率与社会经济和行为因素之间的关系。使用内容分析法分析研讨会数据。
结果：男性最有可能考虑使用的前三种艾滋病预防产品是每月药丸（74.6%）、单剂 PrEP 植入物（62.7%）和事件驱动的口服 PrEP（59.2%）。如果有一种预防选择，31.7%的参与者表示他们将使用每月口服药丸，28.2%将使用每六个月注射一次，19.7%将使用单剂 PrEP 植入物。注意到四个关键主题对潜在单剂 PrEP 使用率有影响：“健康至上”、“单剂 PrEP 植入物的担忧”、“单剂 PrEP 使用的潜在披露”和“信息传播渠道”。参与者更喜欢社交媒体和主流媒体作为信息传播渠道，以获取有关艾滋病预防服务的信息，包括单剂 PrEP 植入物。
结论：在这项研究中，在南非主要为异性恋男性中，对长效艾滋病预防方法有兴趣，但对单剂 PrEP 植入物有担忧。需要对植入物进行全面和参与性的介绍，以提高可接受性并解决潜在问题。应考虑使用社交媒体和健康运动的需求创造策略来吸引和接触男性。
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