Table 1

Barriers and facilitators of PrEP services when PrEP was accessed through FP services

PrEP indicatorBarriersFacilitators
  • Kenya: AGYW ≤18 years of age were less aware of PrEP

  • Kenya: AGYW with regular employment; AGYW engaged in transactional sex or condomless sex in the last 6 months were more likely to take up PrEP

  • Kenya: Low perceived risk for HIV reduced PrEP uptake

  • Zimbabwe: Fear of pill burden, wanting partner’s consent or fearing partner’s reaction to PrEP, satisfied with current method of HIV prevention

  • USA: PrEP stigma reduced uptake

  • USA: Perception of PrEP being too new and mistrust in the medical community reduced uptake

  • Kenya: Unmarried women, women with an HIV positive partner, women >24 years of age were more likely to take up PrEP

  • Zimbabwe: High HIV risk perception, preference for PrEP over other HIV prevention methods, perceived severity of living with HIV, confidence in PrEP

  • USA: Clinical tools for provider and education material for clients increased PrEP uptake

  • Zimbabwe: Unaccustomed to taking pills, religious issues, travel out of town, clinic schedule/hours, lack of transport funds, misunderstanding dosing guidance, side effects

  • Kenya: Low perceived risk of acquiring HIV, finding out partner was HIV negative, side effects, pill burden, fear of intimate partner violence reduced continuation of PrEP

  • Zimbabwe: Focus on original motivation, establishing daily pill routine, accessible PrEP pill storage, planning ahead before travel out of town, partner or facility support impacted positively on PrEP continuation

  • AGYW, adolescent girls and young women; FP, family planning; PrEP, pre-exposure prophylaxis.