Ntimani Junior M, Mokoena-de Beer Andile G, Phetlhu Deliwe R
Department of Nursing Science, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
South Afr J HIV Med. 2025 Apr 17;26(1):1684. doi: 10.4102/sajhivmed.v26i1.1684. eCollection 2025.
Maximising the use of HIV pre-exposure prophylaxis (PrEP) is crucial to eliminate new HIV transmissions, especially in high-prevalence areas such as South Africa. Strengthening access and acceptability of PrEP is essential for effective HIV prevention and to ensure sufficient uptake among those at risk.
This review aims to explore the existing PrEP delivery models in the South African public health settings and their influence on its uptake.
An integrative review approach was followed and electronic databases, namely PubMed, Medline, EBSCOhost, and Google Scholar, were searched. We selected qualitative and quantitative studies that focused on South Africa, written in English, and were published in peer-reviewed journals between 2016 and 2024.
Two distinct models were identified, namely the health facility-based model and the community-based model which is inclusive of the use of pharmacies. Both models have constraints and facilitators that impact on access and acceptability, thus influencing uptake.
Decentralisation as a means to ensure access, and awareness to facilitate acceptability, are critical drivers of the PrEP service's success. Therefore, it is critical to develop intervention strategies that focus on access and acceptability among the target population, driven by the need to overcome barriers and ensure sustainability.
最大限度地利用艾滋病毒暴露前预防（PrEP）对于消除新的艾滋病毒传播至关重要，尤其是在南非等高流行地区。加强PrEP的可及性和可接受性对于有效的艾滋病毒预防以及确保高危人群的充分使用至关重要。
本综述旨在探讨南非公共卫生环境中现有的PrEP提供模式及其对PrEP使用的影响。
采用综合综述方法，检索了电子数据库，即PubMed、Medline、EBSCOhost和谷歌学术。我们选择了2016年至2024年间发表在同行评审期刊上、以英文撰写且聚焦于南非的定性和定量研究。
确定了两种不同的模式，即基于医疗机构的模式和包括使用药店在内的基于社区的模式。两种模式都有影响可及性和可接受性的制约因素和促进因素，从而影响使用情况。
权力下放作为确保可及性的手段，以及提高认识以促进可接受性，是PrEP服务成功的关键驱动因素。因此，至关重要的是制定侧重于目标人群可及性和可接受性的干预策略，这是由克服障碍和确保可持续性的需求所驱动的。
