{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T11:00:01Z","timestamp":1775214001621,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T00:00:00Z","timestamp":1714608000000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>South African men face a substantial burden of HIV and are less likely to test for HIV and initiate antiretroviral therapy if tested positive and more likely to die from AIDS\u2010related causes than women. In addition to condoms and circumcision, guidelines provide for the use of daily oral pre\u2010exposure prophylaxis (PrEP) as an HIV prevention intervention for any men who recognize their need and request PrEP. However, heterosexual men have not been a focus of PrEP programmes, and since its introduction, there is limited literature on PrEP use among men in South Africa. This study explores the experiences, motivators and barriers to oral PrEP use among heterosexual men accessing primary healthcare services in South Africa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study forms part of a mixed\u2010methods implementation science study aimed at generating evidence for oral PrEP introduction and conducted in primary healthcare clinics in South Africa since 2018. Men aged \u226515 years who initiated oral PrEP and enrolled in a parent cohort study were purposefully invited to participate in an in\u2010depth interview (IDI). Between March 2020 and May 2022, 30 men participated in IDIs exploring their motivators for PrEP use, and experiences with accessing health services. Interviews were audio recorded, transcribed and analysed thematically.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The final analysis included 28 heterosexual men (18\u201356 years old). Motivations to initiate PrEP included fear of acquiring HIV, self\u2010perceived vulnerability to HIV and mistrust in relationships; health systems factors which motivated PrEP use included the influence of healthcare providers, educational materials and mobile services. Perceived reduction in HIV vulnerability and changing proximity to partners were reasons for PrEP discontinuation. Side effects, daily\u2010pill burden and stigma were noted as challenges to PrEP use. Health system barriers to PrEP use included limited PrEP availability, school and work demands, and inconsistent mobile clinic schedules.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study reports on the experiences of heterosexual men accessing oral PrEP in real\u2010world settings and contributes to the limited literature among this population. We highlight multiple levels which could be strengthened to improve men's PrEP use, including individual support, education among partners and communities, and addressing health system barriers to access.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26249","type":"journal-article","created":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T08:09:26Z","timestamp":1714637366000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Experiences of oral pre\u2010exposure prophylaxis use among heterosexual men accessing sexual and reproductive health services in South Africa: a qualitative study"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5089-6015","authenticated-orcid":false,"given":"Fatima Abegail","family":"Cholo","sequence":"first","affiliation":[{"name":"Wits RHI University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6816-2116","authenticated-orcid":false,"given":"Siphokazi","family":"Dada","sequence":"additional","affiliation":[{"name":"Wits RHI University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8177-1944","authenticated-orcid":false,"given":"Catherine Elizabeth","family":"Martin","sequence":"additional","affiliation":[{"name":"Wits RHI University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7039-1949","authenticated-orcid":false,"given":"Saiqa","family":"Mullick","sequence":"additional","affiliation":[{"name":"Wits RHI University of the Witwatersrand  Johannesburg South 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research.Geneva;2012."},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-015-0850-2"},{"key":"e_1_2_12_9_1","unstructured":"National Department of Health.Guidelines for expanding combination prevention and treatment options for sex workers: oral pre\u2010exposure prophylaxis (PrEP) and test and treat (T&T).2016."},{"key":"e_1_2_12_10_1","unstructured":"National Department of Health.Guidelines for expanding combination prevention and treatment options: oral pre\u2010exposure prophylaxis (PrEP) and test and treat (T&T).2017."},{"key":"e_1_2_12_11_1","unstructured":"Department of Health Republic of South Africa.Monthly Oral PrEP Report September 2023.Pretoria South Africa:Department of 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