Unpacking the integration of HIV PrEP into family planning services for adolescent girls and young women in Vhembe District, South Africa: key success facilitators and barriers

Universal access to sexual and reproductive health services for adolescent girls and young women (AGYW) in Sub-Saharan Africa is limited. As a result, AGYW in South Africa lack access to and use of Pre-Exposure Prophylaxis (PrEP), exposing them to HIV at an early stage. Several factors contribute to the under-utilisation of PrEP and contraceptives in public health care facilities, including a lack of awareness of these services in Vhembe District. Therefore, this study explored the multilevel barriers and facilitators that affect the integration of PrEP into family planning services using a qualitative approach for improving the sexual health outcomes of AGYW at selected facilities in Vhembe District, Limpopo. In this study, the researcher sampled ( n = 24) health care providers (nurses) within the selected health care facilities in Vhembe District, Limpopo province, using convenience sampling. Interviews were used to collect data from respondents (nurses) until data saturation was reached. An in-depth analysis of the qualitative data was conducted using a thematic approach. To ensure the reliability and validity of the analysis, independent co-coders were consulted to validate the codes. In this study, participants noted several barriers to integrating PrEP into family planning services, including ineffective implementation and monitoring of existing interventions, insufficient resources for implementing PrEP, and a significant challenge: limited knowledge among health care providers regarding PrEP. Several facilitators were also identified for the successful integration of PrEP into family planning services, including community support, motivated staff, technical support and stakeholder collaboration. Improving the sexual and reproductive health outcomes of AGYW in Vhembe District requires concrete action, particularly in rural areas. To expand coverage of services for family planning and HIV prevention for AGYW in high HIV burden areas, family planning clients should be routinely offered HIV testing and PrEP options in addition to a choice of contraceptive methods.