Chiaborelli Malena, Kopeka Mamaswatsi, Sekhesa Pontšo, Sehrt Madeleine, Mohloanyane Tsepang, Ballouz Tala, Menges Dominik, Brown Jennifer A, Belus Jennifer M, Gerber Felix, Raeber Fabian, Williams Andréa, Jackson-Perry David, Hyöky Meri, Conserve Donaldson F, Hampanda Karen, Amstutz Alain
Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.
Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
BMC Public Health. 2025 Jul 2;25(1):2202. doi: 10.1186/s12889-025-23435-3.
Adolescent girls and young women in southern Africa are disproportionately affected by HIV and sexual and reproductive health (SRH) challenges. There is a need for more accessible and de-medicalized community spaces to offer HIV/SRH services for this key population. We aimed to assess the acceptability and feasibility of offering HIV/SRH services at hair salons in Lesotho.
We used an innovative citizen scientist mixed-methods approach, whereby hair stylists were recruited through social media, completed questionnaires, and recruited women clients aged 15-35 years as respondents. A stepwise verification process including GPS, pictures, and a local mobile payment system ensured data quality. Subsequently, we conducted individual in-depth interviews among 14 stylists and clients, following the rapid thematic analysis framework, supported by natural language processing. Clients and stylists were involved at the design, implementation, and results interpretation stage.
We recruited 157 hair stylists (median age 29; [interquartile range 25-33]; across all ten districts of Lesotho) and 308 women clients (median age 26 [22-30]). Among stylists, 93.6% were comfortable offering oral HIV self-testing (HIVST), 92.4% pre-exposure prophylaxis (PrEP), and 91.7% post-exposure prophylaxis (PEP). Among clients, 93.5%, 88.3%, and 86.4% felt comfortable receiving the above-mentioned services, respectively. Immediate demand for the three services was 30.8%, 22.1%, and 14.9%. Acceptability and demand were higher for family planning methods and menstrual health products. 90.4% of stylists thought that offering HIV/SRH services would positively impact their business. The majority of clients visit their salon once or twice a month. Salons were more accessible than the nearest health facility in terms of cost and time, but only 21.0% have an additional confidential space. Qualitative analysis confirmed high acceptability of hair salons as an accessible, less judgemental space than clinics, but raised concerns regarding confidentiality and stylists' roles.
This study suggests that offering HIV/SRH services in hair salons in Lesotho seems to be largely acceptable and feasible with some addressable barriers, based on survey data. A pilot intervention, guided by this study's recommendations, is warranted to translate these findings into practice.
南部非洲的少女和年轻女性受艾滋病毒以及性与生殖健康（SRH）挑战的影响尤为严重。需要有更多便于使用且非医学化的社区空间，为这一关键人群提供艾滋病毒/性与生殖健康服务。我们旨在评估在莱索托的美发沙龙提供艾滋病毒/性与生殖健康服务的可接受性和可行性。
我们采用了一种创新的公民科学家混合方法，通过社交媒体招募发型师，让他们完成问卷，并招募15至35岁的女性客户作为受访者。包括全球定位系统、照片和当地移动支付系统在内的逐步验证过程确保了数据质量。随后，我们按照快速主题分析框架，在自然语言处理的支持下，对14名发型师和客户进行了个人深入访谈。客户和发型师参与了设计、实施和结果解读阶段。
我们招募了157名发型师（中位年龄29岁；[四分位间距25 - 33岁]；覆盖莱索托所有十个区）和308名女性客户（中位年龄26岁[22 - 30岁]）。在发型师中，93.6%愿意提供艾滋病毒自我检测（HIVST），92.4%愿意提供暴露前预防（PrEP），91.7%愿意提供暴露后预防（PEP）。在客户中，分别有93.5%、88.3%和86.4%愿意接受上述服务。对这三项服务的即时需求分别为30.8%、22.1%和14.9%。计划生育方法和月经健康产品的可接受性和需求更高。90.4%的发型师认为提供艾滋病毒/性与生殖健康服务会对他们的业务产生积极影响。大多数客户每月去一次或两次美发沙龙。在成本和时间方面，美发沙龙比最近的医疗机构更容易到达，但只有百分之二十一的美发沙龙有额外的私密空间。定性分析证实，美发沙龙作为一个比诊所更容易到达、评判性更低的空间具有较高的可接受性，但也引发了对保密性和发型师角色的担忧。
这项研究表明，根据调查数据，在莱索托的美发沙龙提供艾滋病毒/性与生殖健康服务在很大程度上似乎是可接受和可行的，但存在一些需要解决的障碍。有必要根据本研究的建议进行试点干预，将这些发现转化为实践。
