A case study on Brothers for Life campaign: demand creation for oral PrEP among AGYW through exploring the perceptions and acceptability of males on the implementation of Pre-exposure prophylaxis (PrEP) in Vulindlela, KwaZulu-Natal.

Abstract

HIV prevalence in South Africa remains high among Adolescent girls and young women particularly in male counterparts in rural KwaZulu-Natal. Perpetuation of HIV in rural KZN is due to multiple factors including cultural beliefs, practices, and values. Nevertheless, the introduction of Pre– exposure prophylaxis (PrEP) for HIV prevention has presented an opportunity not only for a decline in general HIV mortality but also a prevention method that is female - centred already existing HIV prevention methods. Previous case studies have demonstrated the efficacy of Oral PrEP, but it remains ineffective for AGYW because much of it relied on the negotiation with partners. Therefore, this study set out to explore male involvement in Oral PrEP mobilization by understanding the perceptions and support of men in heterosexual relationship and fathers of AGYW in Vulindlela. Using the Social Cognitive Theory (SCT) within the Social Ecological Model, this study explored the relevance of a B4L poster approach with two specific groupings of males, firstly those who are in heterosexual relationships aged 24- 35 years and secondly male parents (also referred to as fathers in this study) who are aged 35 - 49 years in Vulindlela, South Africa. This study employed the qualitative approach, using focus groups and action media to gain an understanding of males’ perceptions and support of Oral PrEP uptake among young women. Findings reveal that even though Oral PrEP is a female centered prevention method and previous interventions were implemented to encourage women, male involvement is important. The support of male partners and fathers to daughters has the potential to promote acceptance of Oral PrEP. However, trust in heterosexual relationships remains an issue for acceptance of Oral PrEP among young women and fathers believe that promoting Oral PrEP to their daughters is encouraging promiscuous behaviour. Also, encouraging male partners to take Oral PrEP may assist in preventing female partners from contracting HIV because they are in multiple intimate relationships. Findings also presented that a poster can be an effective medium of communication if factors such as language, posters are displayed in relevant spaces to reach a wider audience, role modelling and poster is attractive. Key Words: Pre-Exposure Prophylaxis, Human Immunodeficiency Virus, Brothers’ for Life, Adolescent Girls and Young Women, Male involvement, Participatory Action Research.