Pre-Exposure Prophylaxis (PrEP) therapy in KwaZulu-Natal : an implementation guideline

Abstract

Why is pre-exposure prophylaxis (PrEP) therapy not implemented as a preventative treatment against human immunodeficiency virus (HIV) in primary health care (PHC) clinics in the KwaZulu Natal province? PrEP therapy has proven to be an effective preventative strategy against HIV (Bekker et al. 2016) which could be used to decrease the number of individuals becoming infected with the Human Immunodeficiency virus. This study explores the perceptions of PHC nurses, PHC doctors, PHC support staff and individuals at high risk of contracting HIV regarding PrEP therapy in KwaZulu Natal public clinics. The Department of Health (DoH) has published guidelines for the implementation of PrEP therapy; however, the guidelines have not been adopted and used by the primary health care staff in the clinics and has resulted in pre-exposure prophylaxis therapy not being implemented in the clinics to individuals at high risk of contracting Human Immunodeficiency Virus. This research employed a qualitative framework using the grounded theory approach of Charmaz (2014). There are ten districts in KwaZulu Natal with a total of 588 primary health clinics that are accessible to the public. Five primary health care clinics were used in this research study with fourteen participants that were interviewed. Using semi-structured interviews with research participants across primary health care clinics that were purposefully selected, the researcher was able to develop an implementation guide for the department of health (DoH) pre-exposure prophylaxis therapy guidelines. The implementation guide that has been developed can be used by health care providers to assist with the implementation of the department of health pre-exposure prophylaxis therapy guideline in the primary health care clinics. The results of the study showed that educating the public and the individuals at high risk of contracting HIV can create awareness and demand for pre-exposure prophylaxis therapy. Participants expressed their concern regarding the implementation of pre- exposure prophylaxis in the primary health care clinics as there may not be enough resources to successfully implement and monitor individuals that want to take pre- exposure prophylaxis therapy.