{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T05:54:27Z","timestamp":1781848467855,"version":"3.54.5"},"reference-count":25,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-037064"],"award-info":[{"award-number":["INV-037064"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Community pharmacies increasingly serve as access points for HIV pre-exposure prophylaxis (PrEP) in South Africa and understanding how PrEP users in these settings make decisions about condom-use is essential to inform effective combination prevention strategies. This study explored condom-use decision-making among PrEP users accessing pharmacy-delivered services in South Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This qualitative study formed part of the midline evaluation of the PPrEPP-SA project. In-depth interviews were conducted between March and May 2024. Interviews explored participants\u2019 understanding of PrEP, sexual behaviours, perceptions of HIV\/STI risk, and experiences with prevention methods. Audio-recorded interviews were transcribed verbatim and analysed thematically using Braun and Clarke\u2019s inductive approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>69 PrEP users aged 18\u201359 years were recruited from 10 community pharmacies across Gauteng and the Western Cape. Participants demonstrated varied and often negotiated condom-use practices while on PrEP. While most understood PrEP as effective for HIV prevention, some held misconceptions regarding its ability to prevent STIs, contributing to reduced condom-use. Decisions to forego condoms were linked to trust in partners, relationship stability, cohabitation, and preferences for condomless physical intimacy. Condom-use was more likely in casual partnerships or when partner HIV status was unknown. Participants also expressed a strong preference for purchased condoms over free public-sector condoms, citing concerns about quality and durability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Condom-use among pharmacy-based PrEP users is context-dependent, shaped by relationships, risk perceptions, and understandings of PrEP. In South Africa, pharmacy-delivered PrEP programmes provide a critical opportunity to reinforce dual prevention messaging, address misconceptions, and improve access to acceptable, high-quality condoms as part of comprehensive HIV and sexual health prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09564624261442291","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T22:39:16Z","timestamp":1776119956000},"page":"853-860","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Condom-use decision making among pre-exposure prophylaxis (PrEP) users in a pharmacy-delivered PrEP project in South Africa: Qualitative insights from PPrEPP-SA"],"prefix":"10.1177","volume":"37","author":[{"given":"Mafanato Gladys","family":"Maluleka","sequence":"first","affiliation":[{"name":"Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelechi Elizabeth","family":"Oladimeji","sequence":"additional","affiliation":[{"name":"Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne","family":"Singh","sequence":"additional","affiliation":[{"name":"Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nokukhanya","family":"Ntombela","sequence":"additional","affiliation":[{"name":"Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thato","family":"Motlalane-Kopanye","sequence":"additional","affiliation":[{"name":"Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindisipo","family":"Zangqa","sequence":"additional","affiliation":[{"name":"Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athini","family":"Nyatela","sequence":"additional","affiliation":[{"name":"Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Tembo","sequence":"additional","affiliation":[{"name":"Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3597-1643","authenticated-orcid":false,"given":"Samanta Tresha","family":"Lalla-Edward","sequence":"additional","affiliation":[{"name":"Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg South Africa"},{"name":"Utrecht University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"issue":"4","key":"e_1_3_7_2_2","first-page":"2","article-title":"SABSSM VI: an evolving epidemic with persistent challenges","volume":"22","author":"Oosthuizen A","year":"2024","unstructured":"Oosthuizen A. SABSSM VI: an evolving epidemic with persistent challenges. HSRC Review 2024; 22(4): 2\u201313.","journal-title":"HSRC Review"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.4102\/safp.v63i1.5326"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002927"},{"key":"e_1_3_7_5_2","first-page":"87","article-title":"Inequality in health care services in urban and rural settings in South Africa","volume":"27","author":"Ngene NC","year":"2023","unstructured":"Ngene NC, Khaliq OP, Moodley J. Inequality in health care services in urban and rural settings in South Africa. Afr J Reprod Health 2023; 27: 87\u201395. https:\/\/doi.org\/10.29063\/ajrh2023\/v27i5s.11","journal-title":"Afr J Reprod Health"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/19317611.2020.1851334"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/8960943"},{"key":"e_1_3_7_8_2","volume-title":"WHO implementation tool for pre-exposure prophylaxis (PrEP) of HIV infection: provider module for oral and long-acting PrEP","year":"2024","unstructured":"WHO implementation tool for pre-exposure prophylaxis (PrEP) of HIV infection: provider module for oral and long-acting PrEP. World Health Organization, 2024."},{"key":"e_1_3_7_9_2","first-page":"95","article-title":"Awareness and openness to the use of PrEP among a nationally representative sample of South African adults","volume":"48","author":"Nkosi L","year":"2024","unstructured":"Nkosi L, Mmem QD, Tsafa TN, et al. 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