Official websites use. Share sensitive information only on official, secure websites. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. In addition, we held 11 focus group discussions FGDs with a total of healthcare providers. Respondents expressed positive attitudes toward PrEP, owing to experienced and perceived personal, familial, and societal benefits.
PrEP was viewed as i an opportunity for serodiscordant couples to remain together, ii a means of conceiving children with minimized risk of HIV infection, iii providing a sense of agency and control, and iv an avenue for addressing the HIV epidemic in Lesotho.
However, respondents also reported that several important misconceptions of PrEP were common among adults in Lesotho, including a belief that PrEP protects against sexually transmitted infections other than HIV, promotes promiscuity, prevents pregnancy, causes seroconversion, and provides lifelong protection from taking the pill just once. Behavioral HIV prevention interventions have demonstrated limited success in changing risky sexual practice, thereby suggesting a need for integrated and innovative approaches to HIV control [ 2 ].
A phased PrEP implementation strategy was used, with five of the ten Lesotho districts selected for the first stage, which included PrEP delivery through both facility- and community-based models.
PrEP scale up to the remaining districts began in Studies on PrEP awareness have been predominantly conducted in high-income countries [ 9 β 15 ], and largely among Men who have Sex with Men MSMs [ 10 , 11 , 13 , 15 β 18 ] and healthcare providers [ 12 , 19 , 20 ]. Research in sub-Saharan Africa done in this area has mostly been carried out in the context of large-scale clinical trials [ 21 β 23 ]. Our research was conducted as part of a larger implementation study, whose goal was to gain a deeper understanding of the ongoing Lesotho PrEP program and scale up process across the health system.
