Experiences of adolescent girls and young women of oral PrEP uptake in rural KwaZulu-Natal

Background: The human immunodeficiency virus remains a global public health concern mainly affecting adolescent girls and women. Pre-exposure prophylaxis (PrEP) uptake among this group remains low in the Richmond rural community despite known benefits. Aim: This article explores the experiences of adolescent girls and young women aged 18–24 of oral PrEP uptake in Richmond Local Municipality, KwaZulu-Natal, South Africa. Setting: The study was carried out in the peri-urban area with two traditional councils located in the uMgungundlovu district of KwaZulu-Natal, South Africa. Methods: Using qualitative methodology, 12 in-depth interviews were conducted among participants who had used PrEP between 1 month and 12 months. These interviews were thematically analysed using Colaizzi’s method. Results: Thematic analysis identified four themes capturing the experiences of adolescent girls and young women regarding PrEP uptake: (1) perceived factors influencing usage decisions, (2) barriers to uptake, (3) facilitators of continued use, (4) community education and awareness about PrEP. Barriers like stigma, healthcare access challenges and fear of side effects further hindered initiation, adherence and retention. Facilitators for continuation included family, community support and convenient access to re-supply. The study highlights the importance of school-based parental meetings and discussions to normalise PrEP use among participants in the peri-urban area. Conclusion: The identified practical approaches enable convenient resupply and could increase the uptake. Peer support is critical in improving side effect management. Contribution: The study highlights the need to improve social support by using the school’s parental meetings to educate the community about the benefits of pre-exposure prophylaxis to improve adherence and retention.