Exploring acceptability of oral PrEP prior to implementation among female sex workers in South Africa

Abstract Introduction Female sex workers ( FSW s) are at high‐risk for HIV acquisition in South Africa, where the advent of new HIV prevention and treatment interventions represent the potential to significantly impact the epidemic. This paper focuses on aspects of Pr EP acceptability as a new intervention within the context of a larger service delivery programme including the simultaneous rollout of early ART . This paper explores Pr EP acceptability among the FGD participants as future potential users. Methods FGD s were conducted in two clinic‐based sites in Johannesburg and Pretoria. They aimed to explore community‐level, multi‐dimensional acceptability of Pr EP within the context of imminent implementation alongside early ART in the TAPS Demonstration Project. Sex worker peer educators recruited participants from varying sex work locales. Facilitation was in English with adaptation by facilitators into local languages as needed. Transcripts were translated and transcribed into English. Thematic analysis was used to analyse the data. Results Four FGD s were conducted in each site for a total of eight FDG s and 69 participants. Demographics were largely similar across the sites. Overall, there was strong acceptability of Pr EP among participants and positive anticipation for the imminent delivery of Pr EP in the local sex worker clinics. Themes arising from the discussions exploring aspects of Pr EP acceptability included: awareness and understanding of Pr EP ; Pr EP motivations including choice, control, and vulnerability, managing Pr EP risks and worries; and, de‐stigmatizing and empowering Pr EP delivery. Participant discussions and recommendations highlighted the importance of developing clear education and messaging to accurately convey the concept of Pr EP , and intervention integration into supportive and tailored services. Conclusions Through the course of these FGD s, Pr EP became a positive and highly anticipated prevention option among the FSW s participants who endorsed implementation in their communities. Effective integration of Pr EP into existing services will include comprehensive health programming where ART is also available, appropriate messaging, and support.