Awareness and openness to the use of PrEP among a Awareness and openness to the use of PrEP among a nationally representative sample of South African nationally representative sample of South African adults adults

Introduction: South Africa adopted for preIntroduction: South Africa adopted for preexposure prophylaxis (PrEP) in 2016, becoming the exposure prophylaxis (PrEP) in 2016, becoming the first African country to do so. Yet to date, uptake first African country to do so. Yet to date, uptake has been underwhelming, only about 165,000 has been underwhelming, only about 165,000 South Africans were reported to be on PrEP in midSouth Africans were reported to be on PrEP in mid2021. Lack of awareness has been cited as a 2021. Lack of awareness has been cited as a contributory factor for the low uptake, but this has contributory factor for the low uptake, but this has never been examined using a nationally never been examined using a nationally representative sample. Methods: we investigated representative sample. Methods: we investigated this among a national sample of HIV seronegative this among a national sample of HIV seronegative adults. Data were from the 2017/2018 South adults. Data were from the 2017/2018 South African National HIV Prevalence, Incidence, African National HIV Prevalence, Incidence, Behaviour and Communication Survey. Awareness Behaviour and Communication Survey. Awareness and openness to using PrEP were self-reported. and openness to using PrEP were self-reported. Weighted percentages were calculated overall and Weighted percentages were calculated overall and by demographic characteristics. Results: overall, by demographic characteristics. Results: overall, only 3.2% of seronegative adults spontaneously only 3.2% of seronegative adults spontaneously reported PrEP as a way of preventing HIV. Overall, reported PrEP as a way of preventing HIV. Overall, 69.6% were open to using PrEP, from 58.2% in 69.6% were open to using PrEP, from 58.2% in Western Cape, to 78.5% Northern Cape. Openness Western Cape, to 78.5% Northern Cape. Openness was highest among the youngest age group (18-29 was highest among the youngest age group (18-29 years, 78.3%) and lowest among the oldest (60+ years, 78.3%) and lowest among the oldest (60+ years, 45.6%). Striking racial differences were years, 45.6%). Striking racial differences were observed with openness among Black Africans observed with openness among Black Africans (75.4%) being 2.5 times higher than Whites (29.0%). (75.4%) being 2.5 times higher than Whites (29.0%). Among women, openness was 64.7% among those Among women, openness was 64.7% among those currently pregnant, 80.4% among those pregnant in currently pregnant, 80.4% among those pregnant in the past two years but not now, and 67.8% among the past two years but not now, and 67.8% among those who were not pregnant in the past two years those who were not pregnant in the past two years (chi(2)=134.2, p<0.001). Among males, openness was (chi(2)=134.2, p<0.001). Among males, openness was higher among those circumcised (75.6%) than higher among those circumcised (75.6%) than uncircumcised (64.5%). Conclusion: planning for uncircumcised (64.5%). Conclusion: planning for broad-scale implementation of PrEP within the broad-scale implementation of PrEP within the South African context could build on knowledge South African context could build on knowledge gained from recent implementation and scale-up of gained from recent implementation and scale-up of relevant biomedical interventions (e.g. ART, relevant biomedical interventions (e.g. ART, voluntary medical male circumcision, and family voluntary medical male circumcision, and family planning). planning). Introduction Introduction