Evidence map›Paper›PMID 42432402›Full record

ArticleAIDS and behavior2026

Motivations and Barriers to Sustained PrEP Use Among Men in Buffalo City Metro, South Africa: A Qualitative Study.

Philip John Smith, Joseph Daniels, Linda-Gail Bekker, Andrew Medina-Marino

Abstract read
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In one paragraph

Article in AIDS and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Philip John Smith *The Desmond Tutu HIV Centre, University of Cape Town, Observatory, Cape Town, South Africa. Philip.Smith@hiv-research.org.za.
Joseph DanielsEdson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.
Linda-Gail BekkerThe Desmond Tutu HIV Centre, University of Cape Town, Observatory, Cape Town, South Africa.
Andrew Medina-Marino *Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. andrewmedinamarino@gmail.com.ORCID http://orcid.org/0000-0002-0095-4141

Funding

University of California Launching Future Leaders in Global Health Research Training ProgramD43TW009343 · FIC · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CRAIG R COHEN, Sung-Jae Lee · 2017 to 2026
$14.7M
The Community PrEP StudyR01MH114648 · NIMH · FOUNDATION FOR PROFESSIONAL DEVELOPMENT · PI BEKKER, LINDA-GAIL GAIL, MEDINA-MARINO, ANDREW · 2017 to 2021
$2.4M
FIC NIH HHS D43TW009343NIMH NIH HHS R01MH114648
6 · The paper itself

Abstract

Men in sub-Saharan Africa experience disproportionately poor HIV outcomes, yet their engagement with HIV prevention services remains limited. Although oral pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy, relatively little research has examined the factors that support men's sustained use of PrEP after initiation. We conducted a qualitative sub-study among men who initiated PrEP through a community-based HIV prevention program in Buffalo City Metro, South Africa. Men who returned for their three-month PrEP refill were invited to complete an in-depth interview. Thematic analysis was guided by the Network-Individual-Resource Model. Twelve of 22 men who initiated PrEP returned for their three-month follow-up visit and participated in interviews. Men described several interconnected factors supporting continued PrEP use. Awareness of sexual risk and confidence in PrEP's protective benefits motivated continued use, while encouragement from partners and trusted male peers reinforced adherence. Participants also described developing daily routines that helped integrate PrEP into their lives. Structural conditions further shaped engagement: men preferred convenient community-based PrEP services, while anxiety surrounding routine HIV testing was described as discouraging for men more broadly, although many participants reported that their own concerns diminished with repeated testing. Men's sustained PrEP use was shaped by networked mental and tangible resources, including risk awareness, social support, adherence routines, and accessible service delivery environments. Community-based PrEP delivery models that leverage men's social networks may help improve sustained PrEP engagement among men in high HIV burden settings.

Indexed as

HIV preventionMenNetwork-individual-resource modelPre-exposure prophylaxis (PrEP)PrEP persistenceSouth Africa

Identifiers

PMID42432402

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.