ArticleSocial science & medicine (1982)2024
Applying CFIR to assess multi-level barriers to PrEP delivery in rural South Africa: Processes, gaps and opportunities for service delivery of current and future PrEP modalities.
Article in Social science & medicine (1982), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Integrating Legal Aid into HIV Care: Evaluating the Impact of a Medical-Legal Partnership on Viral Suppression Outcomes.AIDS and behavior · 2026Trial
- Anticipated Determinants and Strategies Supporting Same-Day HIV Preexposure Prophylaxis Implementation During Emergency Care Encounters in Kenya: A Qualitative Study.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Barriers and facilitators of the implementation of a leadership training program based on the Developing and Sustaining Nursing Leadership Best Practice Guideline: A qualitative study.International journal of nursing sciences · 2026Article
- Review
- "O for KP": an evidence review on recentering HIV prevention and PrEP delivery for key populations and the underserved.Current opinion in infectious diseases · 2026Review
- Knowledge, attitudes, and behavioural intention towards HIV pre-exposure prophylaxis among health science students in South Africa: cross-sectional study.Frontiers in public health · 2026Article
- A turning point for youth HIV care in the United States: tailored strategies for adolescents and young adults.Critical public health · 2026Article
- Factors influencing PrEP adoption in sexual health clinics within Ontario's public health system: a qualitative study using the Consolidated Framework for Implementation Research (CFIR).Frontiers in public health · 2026Article
- A Qualitative Consolidated Framework for Implementation Research Evaluation of Innovative PrEP Delivery During COVID-19 Among Adolescent Girls and Young Women in North West Province, South Africa.International journal of environmental research and public health · 2025Article
- Building HIV/AIDS prevention communication strategies through community-informed formative research for a biobehavioural couple-based HIV prevention intervention for Latino men who have sex with men.BMJ public health · 2025Article
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Authors and funding
6 authors.
Funding
Abstract
Despite established efficacy for oral pre-exposure prophylaxis (PrEP) in reducing HIV incidence, multi-level barriers within the health system, clinics, and the processes that shape practice have hindered service delivery and subsequent population-level effects. We applied the Consolidated Framework for Implementation Research (CFIR) to assess the context of PrEP delivery for adolescent girls and young women (AGYW) in rural South Africa and identify the factors supporting and impeding PrEP implementation to develop strategies to improve PrEP delivery. Between 2021 and 2022, we conducted in-depth interviews with five young women with PrEP use experience and 11 healthcare providers as well as four key informant stakeholder interviews. Tailored interviews organized around the CFIR domains provided multiple perspectives on the inter-connected processes, gaps, and opportunities between health systems, clinics, communities, and PrEP services. Shifts in PrEP policies, funding pressures, and inconsistent communications from the National Department of Health spurred fragmented planning, engagement, execution, and monitoring of PrEP delivery processes within clinics already struggling to address multiple population health needs. Resulting challenges included: conflicting priorities within clinics and across NGO partners, unclear goals and targets, staffing and space constraints, and insufficient community engagement. Individual clinics' implementation climate and readiness to deliver PrEP varied in terms of operational plans and delivery models. Interviewees reported complexity of initiation procedures and support for PrEP maintenance, with opportunities to improve systems communications and processes to facilitate integrated services and more user-friendly experiences. Applying CFIR identified opportunities to strengthen PrEP delivery across levels within this complex service delivery setting.
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