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We explored preferences for long-acting PrEP and multipurpose prevention technologies among pregnant and breastfeeding women (PBFW) without HIV. From April to December 2023, we conducted a discrete choice experiment at maternal healthcare clinics in Cape Town, East London (South Africa), and Gaborone (Botswana) including PrEP-experienced and PrEP-naive women. Analysis included site stratification, mixed-effects logistic regression, and latent class modeling. Among 450 pregnant and breastfeeding women (52% pregnant, 47% breastfeeding), vaginally inserted and implanted PrEP was least preferred compared to oral. East London and Gaborone preferred clinic PrEP pick-up and effectiveness, while Cape Town showed indifference for community delivery. Three latent classes emerged: \u2018comprehensive delivery seekers\u2019 (43%), \u2018physical and physiological prioritisers\u2019 (25%), and \u2018vaginal insertion avoiders\u2019 (32%). Future PrEP programs should prioritize user-centered approaches, aligning with user preferences for effective use.<\/jats:p>","DOI":"10.1007\/s10461-025-04751-6","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:36:52Z","timestamp":1747787812000},"page":"2963-2975","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Preference for Service Delivery for Long-Acting Pre-exposure Prophylaxis for HIV Infection Among Pregnant and Breastfeeding Women in South Africa and Botswana"],"prefix":"10.1007","volume":"29","author":[{"given":"Lindsey","family":"de Vos","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aamirah","family":"Mussa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elzette","family":"Rousseau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Strauss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gavin","family":"George","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prisca","family":"Vundhla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avuyonke","family":"Gebengu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maipelo","family":"Tsuaneng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lefhela","family":"Tamuthiba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aratwa","family":"Tumagole","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neo","family":"Moshashane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chelsea","family":"Morroni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Remco P. 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