Exploring adolescent girls and young women’s oral PrEP readiness from a school based’ perspective in Vulindlela, KZN.

Abstract

Over the past decades, great strides have been made globally in reducing the incidence of new HIV infections. Despite significant breakthroughs in HIV prevention, certain segments of the population continue to experience a rise in new infections. In particular, adolescent girls and young women continue to bear a disproportionate burden of new HIV infections across the world, including South Africa. It is in this context that Oral Pre-Exposure Prophylaxis (Oral PrEP) was introduced as an alternative intervention for the prevention of new infections among individuals at high risk of HIV acquisition. A range of studies have attested to the effectiveness of oral PrEP when used properly alongside other HIV prevention strategies. While its effec-tiveness has been confirmed scientifically, there is limited academic knowledge of the percep-tions of the individuals and structures in the community that would support and facilitate the adoption of Oral PrEP amongst adolescent girls and young women (AGYW). This study sought to understand the role of schools as a community structure in preparing AGYW for Oral PrEP uptake in Vulindlela, a community bearing the greatest burden of HIV infections in rural KZN. Twelve semi-structured interviews were conducted with teachers and school heads in six schools in Vulindlela. A purposive sampling method was used to identify the Life Orientation teachers and senior staff members that were interviewed in the study. The Health Belief Model and the Culture-Centred Approach were used to obtain a detailed under-standing of the topic under study. The results showed that teachers were aware of the HIV risks facing young women in their schools, but had limited knowledge about Oral PrEP and how it works. Generally there were reservations about the distribution and use of Oral PrEP among learners, owing to concerns around increased sexual risk behaviour and promiscuity. The De-partment of Education's stance on HIV prevention in schools was also found to be a barrier to positioning schools as an environment that is conducive for the introduction of Oral PrEP. In order to realise the full potential of Oral PrEP, the cultural barriers in the community should be addressed as these have the potential to hinder or facilitate the uptake of this critical intervention. Community structures such as schools and health centres should be engaged with a view to creating an enabling environment for the uptake of Oral PrEP by school-going girls.