Campus healthcare workers’ knowledge and views on injectable pre-exposure prophylaxis prior to rollout in South Africa: A qualitative study

Abstract

Long-acting injectable pre-exposure prophylaxis (PrEP) offers a promising alternative to daily oral PrEP by addressing adherence challenges. However, successful implementation depends on the readiness and perceptions of primary healthcare (PHC) workers who deliver these services, particularly in campus health clinics serving high-risk youth populations. The objective of this study was to explore PHC workers’ knowledge and views on long-acting injectable HIV PrEP in campus health clinics before its rollout in South Africa. We conducted a qualitative, exploratory, cross-sectional study using semi-structured interviews with a purposive sample of 18 PHC workers from six campus health clinics at a public university in KwaZulu-Natal, South Africa. Data were collected between August and September 2025, and were analyzed thematically using Babchuk’s 10-step process. PHC workers demonstrated limited and variable awareness of injectable PrEP across professional cadres. While participants anticipated improvements in HIV prevention through injectable PrEP regarding adherence and reducing stigma, they expressed confusion about the clinical protocol surrounding injectable PrEP rollout; however, they were hopeful, dependent on the demonstrated success of injectable PrEP. PHC workers currently lack the preparedness required for injectable PrEP delivery. To enable effective rollout, the government must prioritize comprehensive training on clinical and operational protocols.