{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T08:50:07Z","timestamp":1788511807183,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Providing pregnant and lactating people (PLP) with choice in HIV pre\u2010exposure prophylaxis (PrEP) methods, including long\u2010acting injectable cabotegravir (CAB\u2010LA), may mitigate barriers to effective PrEP use. We evaluated PrEP preferences and acceptability among PLP offered CAB\u2010LA versus oral PrEP in South Africa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The PrEPared to Choose study in Cape Town, South Africa, enrolled young people ages 15\u201329 at one public clinic and one community\u2010based mobile clinic. Using informed choice counselling, participants were offered oral PrEP or CAB\u2010LA, with the option to switch methods at follow\u2010up visits over 18 months. We report baseline CAB\u2010LA and oral PrEP initiations among PLP in the study, acceptability of their initial choice within 3 months of enrolment and theoretical preferences regarding PrEP methods that may become available to PLP. We report descriptive statistics and use Chi\u2010square and Fisher's exact to compare responses by initiated PrEP method and pregnancy status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From February to August 2024, we enrolled 58 PLP (<jats:italic>n<\/jats:italic> = 30 pregnant, <jats:italic>n<\/jats:italic> = 28 breastfeeding). Median age 23 years (IQR 19.5\u221226). Of 30 pregnant participants, 23 (77%) initiated CAB\u2010LA and seven (23%) oral PrEP; among 28 breastfeeding participants, 25 (89%) initiated CAB\u2010LA and three (11%) oral PrEP. Of enrolled PLP, 36 (62%, <jats:italic>n<\/jats:italic> = 13 pregnant, <jats:italic>n<\/jats:italic> = 23 breastfeeding) completed the acceptability survey. Of these, 83% (<jats:italic>n<\/jats:italic> = 12\/13 pregnant, <jats:italic>n<\/jats:italic> = 20\/23 breastfeeding) chose and received CAB\u2010LA, and the remaining (<jats:italic>n<\/jats:italic> = 4) chose and received oral PrEP. PLP who received CAB\u2010LA reported liking its ease of use (69%; <jats:italic>n<\/jats:italic> = 22\/32) and long\u2010acting protection (44%; <jats:italic>n<\/jats:italic> = 14\/32). Half of CAB\u2010LA users disliked side effects (e.g. injection site pain), although 41% of PLP (<jats:italic>n<\/jats:italic> = 13\/32) described no CAB\u2010LA dislikes. Almost all (97%; <jats:italic>n<\/jats:italic> = 31\/32) PLP currently using CAB\u2010LA were interested in continuing CAB\u2010LA, and all PLP using oral PrEP reported interest in trying CAB\u2010LA in the future. Eighty\u2010six percent of surveyed PLP (<jats:italic>n<\/jats:italic> = 31\/36) did not want to try the dapivirine vaginal ring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PLP in South Africa had a strong preference for CAB\u2010LA over oral PrEP, and CAB\u2010LA was found to be highly acceptable. Further research is needed to evaluate the effect of offering choice of PrEP methods, including CAB\u2010LA, on PrEP continuation among PLP.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26492","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T07:26:54Z","timestamp":1751441214000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["PrEP preferences and early acceptability of injectable cabotegravir among pregnant and lactating people in Cape Town, South Africa: findings from the PrEPared to Choose study"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3671-5211","authenticated-orcid":false,"given":"Nafisa","family":"Wara","sequence":"first","affiliation":[{"name":"Los Angeles David Geffen School of Medicine University of California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4247-8913","authenticated-orcid":false,"given":"Carey","family":"Pike","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6487-6736","authenticated-orcid":false,"given":"Elzette","family":"Rousseau","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pippa","family":"Macdonald","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pakama","family":"Mapukata","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Leonard","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keitumetse","family":"Lebelo","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9575-4574","authenticated-orcid":false,"given":"Risa","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Los Angeles David Geffen School of Medicine University of California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Orrell","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0755-4386","authenticated-orcid":false,"given":"Linda\u2010Gail","family":"Bekker","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6290-9293","authenticated-orcid":false,"given":"Dvora Joseph","family":"Davey","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Los Angeles David Geffen School of Medicine University of California  Los Angeles California USA"},{"name":"Division of Epidemiology and Biostatistics University of Cape Town School of Public Health  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,2]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"UNAIDS.UNAIDS World AIDS Day 2023 Fact Sheet.2023.https:\/\/www.humanitarianlibrary.org\/sites\/default\/files\/2023\/10\/UNAIDS_FactSheet_en.pdf. 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