Research ArticleHIV

A stepped-wedge randomized trial and qualitative survey of HIV pre-exposure prophylaxis uptake in the Eswatini population

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Science Translational Medicine  23 Sep 2020:
Vol. 12, Issue 562, eaba4487
DOI: 10.1126/scitranslmed.aba4487

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PrEPping to prevent HIV

Clinical trials have demonstrated that pre-exposure prophylaxis (PrEP) can prevent HIV infection in high-risk populations. Geldsetzer et al. conducted a randomized study of health care facilities in Eswatini to see whether promoting PrEP could increase uptake among the general population at high risk of acquiring HIV. They found that the promotion package resulted in a small increase in PrEP uptake, but only one third of at-risk adults, mostly women, agreed to participate in PrEP. Crucially, interviews with study participants and health care workers revealed that PrEP promotion activities needed to be expanded beyond health care facilities into community settings to raise awareness, particularly among men.

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