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Integrating end\u2010user preference into early stage product development may further overcome challenges with future product uptake and adherence. Hence, we sought to optimize the design of a Pr<jats:styled-content style=\"fixed-case\">EP<\/jats:styled-content> implant in early\u2010stage development by gathering opinions about implant attributes from potential end\u2010users in South Africa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted 14 focus group discussions (<jats:styled-content style=\"fixed-case\">FGD<\/jats:styled-content>s) with young women and men aged 18 to 24 in Cape Town and Soshanguve, South Africa, inviting participants into discussion as co\u2010designers. <jats:styled-content style=\"fixed-case\">FGD<\/jats:styled-content>s were homogenous by gender and previous implant experience. During <jats:styled-content style=\"fixed-case\">FGD<\/jats:styled-content>s, we showed prototype devices and followed a semi\u2010structured guide with questions on history of contraceptive implant use, preferences for physical characteristics of an implant, implant biodegradability, insertion process, participant\u2010driven ideas for implant design, and social adoption considerations. <jats:styled-content style=\"fixed-case\">FGD<\/jats:styled-content>s were facilitated in English, isiXhosa, Tswana, isiZulu, or Tsonga, audio\u2010recorded, transcribed into English, and qualitatively coded and analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this qualitative sample of 105 youth (68 women and 37 men), 58 participants were from Soshanguve and 47 from Cape Town, and 23% had previously used contraceptive implants. Participants expressed preferences for several implant design features; specifically, longer duration (\u22656\u00a0months) was more important to most participants than the size or number of devices implanted. A majority preferred a flexible versus stiff implant to minimize palpability, thereby increasing discreetness and comfort. Nearly all participants favoured a biodegradable implant to avoid removal and thus reduce clinic visits. Concerns about the implant centred on its possible side effects and the \u201cplastic\u201d look of the prototype displayed for demonstration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study offers preliminary insights into an implant for <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevention that provides long\u2010lasting protection may be well received among young South Africans. Additionally, flexibility, discreetness, and biodegradability may increase acceptability of the implant. Such end\u2013user feedback is being incorporated into current implant designs in the hope of creating an effective long\u2010acting Pr<jats:styled-content style=\"fixed-case\">EP<\/jats:styled-content> product that is likely to achieve high uptake and adherence in target populations.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25170","type":"journal-article","created":{"date-parts":[[2018,8,30]],"date-time":"2018-08-30T00:23:03Z","timestamp":1535588583000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Perspectives of South African youth in the development of an implant for <scp>HIV<\/scp> prevention"],"prefix":"10.1002","volume":"21","author":[{"given":"Emily A","family":"Krogstad","sequence":"first","affiliation":[{"name":"Desmond Tutu HIV Centre University of Cape Town Cape Town South Africa"},{"name":"RTI International Women's Global Health Imperative San Francisco California 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