MPhil study projects

Factors influencing the uptake, adherence and persistence of adolescent girls and young women on pre-ExposurepProphylaxis (PrEP) in the DREAMS implementation sites in the Shiselweni region of Eswatini: The perspectives of key stakeholders

Student: Nontobeko L Sibandze

Country: Eswatini

Adolescent girls and young women (AGYW) aged 15-24 in Eswatini were significantly more susceptible to HIV infection compared to males of the same age group. In response, Eswatini adopted oral pre-exposure prophylaxis (PrEP) as an HIV prevention strategy in 2017. PrEP uptake, adherence and persistence among AGYW however remained suboptimal.

This thesis examined stakeholder perspectives on factors influencing PrEP uptake, adherence and persistence among AGYW. Data was gathered from six sites in the Shiselweni region, involving healthcare workers and constituency council members. Employing a case study design, the study conducted key informant interviews and focus group discussions.

Barriers to PrEP adherence included misinformation, stigma, limited access to healthcare, stock shortages, AGYW mobility and mandatory PrEP initiation initiation. Enabling factors encompassed mobile clinic outreach, community partnerships and social media PrEP education.

The research underscored PrEP uptake challenges stemming from inadequate information, limited healthcare accessibility and unsuitable delivery modalities for AGYW. It recommended community-based point-of-care centres to enhance accessibility and tailored service provision.