The Effects of the COVID-19 Pandemic on HIV Pre-exposure Prophylaxis Uptake and Retention at Selected Facilities in Eswatini

Background: Oral pre-exposure prophylaxis (PrEP) is the use of antiretroviral medication to reduce HIV acquisition in HIV-negative individuals. In Eswatini, PrEP was introduced in 2017, and the uptake is increasing, despite stigma and COVID-19 challenges. Aim: This study aimed to compare the uptake and retention of PrEP during and after the COVID-19 pandemic. Setting and method: An analytical cross-sectional study design was used. Purposive sampling was used to select five facilities in the Manzini region. The chosen facilities are sites where PrEP was piloted and scaled up before, during, and after the COVID-19 pandemic. The study population was clients accessing HIV testing services in the selected facilities, and data was obtained from the HIV testing register, PrEP register, and the Client Management Information System (CMIS). Clients testing negative and eligible for PrEP, and those initiated on PrEP were followed for retention. PrEP uptake, and retention were assessed during COVID-19 (March 2020 – March 2021) and post-COVID-19 (April 2021 - April 2022).