“We would be killing two birds with one stone”: Assessing perceptions of barbershop-based HIV prevention and sexual health service delivery among clients, barbers, and owners across Durban, South Africa

The South African HIV prevention strategy has largely targeted young women and adolescent girls due to high incidence rates; however, engaging men in prevention is needed to reduce HIV burden. Community-based HIV prevention addresses known barriers to care. Barbershops offer a unique venue to reach men. We sought to evaluate how male clients, barbers, and barbershop owners perceived offering oral or injectable pre-exposure prophylaxis (PrEP) alongside other sexual health services at barbershops across Durban, South Africa. We conducted a qualitative study among owners ( n = 14), barbers ( n = 14), and male clients ( n = 26) (≥ 18 years) in barbershops in Durban, South Africa. We examined the role of the barbershop within the community and perceptions of delivering HIV testing, PrEP, STI screening, and referrals for male circumcision in barbershops. Three research assistants (in US and South Africa) coded transcripts and conducted thematic analysis. Overall, participants reported varied responses to the delivery of HIV prevention and sexual health services in barbershops. Many participants expressed enthusiasm for health services at the barbershop, citing the location’s convenience and accessibility; however, there were concerns about space, changing atmosphere, and privacy during testing and counseling. Participants emphasized the importance of promoting choice and respecting men’s autonomy. Barbershops may be feasible venues to deliver HIV prevention and other sexual health services in South Africa, reaching men who may not otherwise engage with preventative health care. It will be imperative to address concerns about space constraints, privacy, and the potential disruption to the barbershop’s atmosphere. Qualitative formative study nested within related clinical trial. Clinicaltrials.gov identifier: NCT04222504. Registered 01-08-2020.