A stepped-wedge randomized trial and qualitative survey of HIV pre-exposure prophylaxis uptake in the Eswatini population
Pascal Geldsetzer, Kate Bärnighausen, Anita Hettema, Shannon A. McMahon, Shona Dalal, Rachel P. Chase, Catherine E. Oldenburg, Stefan Köhler, Simiao Chen, Phiwayinkhosi Dlamini, Mxolisi Mavuso, Allison B. Hughey, Sindy Matse, Till Bärnighausen
Abstract
= 0.036) relative increase in the number of individuals taking up PrEP, with an absolute increase of 2.2 individuals per month per health care facility. When asked how PrEP uptake could be improved in 217 accompanying in-depth qualitative interviews, interviewees recommended an expansion of PrEP promotion activities beyond health care facilities to communities. Although a health care facility-based promotion package improved PrEP uptake, both uptake and retention remained low. Expanding promotion activities to the community is needed to achieve greater PrEP coverage among adults at risk of HIV infection in Eswatini and similar settings.