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Healthcare workers in Sub-Saharan Africa show positive attitudes toward delivering both oral and injectable HIV PrEPHealthcare Workers Show Positive Attitudes Toward HIV Prevention Medication

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Key Takeaway
Note that while HCW attitudes toward PrEP are positive, infrastructure and training gaps remain significant hurdles.

This narrative review synthesizes the knowledge, perceptions, attitudes, and readiness of healthcare workers (HCWs) in Sub-Saharan Africa regarding the delivery of oral and injectable HIV pre-exposure prophylaxis (PrEP). The scope focuses on identifying implementation barriers and facilitators within specific regions including Uganda, South Africa, Kenya, and Zimbabwe.

The review finds that HCW awareness varies based on prior exposure to pilot initiatives. However, attitudes toward PrEP are generally positive, with providers recognizing its potential to improve patient adherence and reduce stigma. Key facilitators for successful delivery include task-shifting, government commitment, targeted capacity-building, and peer-led learning.

Significant barriers to implementation were identified, including limited training, inadequate infrastructure, increased workloads, and a lack of clear clinical guidelines. A notable limitation is that the majority of existing evidence is derived from oral PrEP implementation rather than injectable formulations. These findings suggest that while HCWs are receptive to PrEP, systemic support and training are necessary for successful scale-up.

How this fits prior evidence

This narrative review addresses a gap in understanding healthcare worker readiness for injectable PrEP by drawing parallels from existing oral PrEP implementation data. It complements the finding that injectable lenacapavir is an effective PrEP alternative to oral formulations by highlighting the systemic barriers and facilitators that affect provider willingness to deliver these treatments in Sub-Saharan Africa.

This review looked at the knowledge and attitudes of healthcare workers in countries like Uganda, South Africa, Kenya, and Zimbabwe. The goal was to see how ready these workers were to provide HIV pre-exposure prophylaxis (PrEP) to their patients.

The findings show that healthcare workers generally have positive views on PrEP because it can help patients stay on their treatment and reduce social stigma. However, their specific level of knowledge varies depending on whether they have worked with previous pilot programs.

Several hurdles were identified for those trying to provide the medication, including a lack of training, poor infrastructure, and heavy workloads. To overcome these, the review suggests that government commitment, peer-led learning, and moving tasks to different staff members can help. Because most of the data comes from oral medications rather than injectable ones, more research is needed specifically on injectable options.

What this means for you:
Healthcare workers favor HIV prevention meds but need better training and infrastructure to provide them effectively.

Common questions

What are the main challenges for healthcare workers providing HIV prevention?

Healthcare workers reported several barriers to delivering PrEP. These include a lack of proper training, inadequate infrastructure, an increase in their daily workload, and a lack of clear clinical guidelines. Overcoming these hurdles is necessary for expanding access to these medications.

What factors help healthcare workers provide HIV prevention more effectively?

Several factors can help improve the delivery of PrEP. These include government commitment, peer-led learning, targeted capacity building, and task-shifting. These strategies can help staff manage their workloads while providing better care to patients.

What are the attitudes of healthcare workers toward HIV prevention medication?

Healthcare workers generally have positive attitudes toward PrEP. They believe it has the potential to improve how well patients follow their treatment plans and can help reduce the social stigma associated with HIV.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
BackgroundLong-acting injectable Human Immunodeficiency Virus (HIV) pre-exposure prophylaxis (PrEP), particularly cabotegravir, presents a promising HIV prevention option in Sub-Saharan Africa (SSA), where HIV prevalence remains high. As frontline providers, healthcare workers (HCWs) are central to PrEP delivery. Given the emerging introduction of injectable PrEP in SSA, this review examines HCW perspectives on PrEP delivery broadly, including both oral and injectable formulations, with particular attention to how oral PrEP implementation experiences inform injectable PrEP readiness.MethodsA narrative review was conducted with a comprehensive literature search across PubMed, Scopus, Web of Science, EBSCOhost, and Google Scholar for English-language studies published 2020–2025. Eligible studies comprised qualitative, quantitative, and mixed-methods primary research that examined healthcare workers’ knowledge, perceptions, attitudes, and readiness to deliver HIV PrEP in SSA. Relevant studies were identified, reviewed, and analyzed thematically to identify key patterns and implementation considerations.ResultsA total of 742 records were identified across databases, and following review, 5 primary studies met the scope criteria, all examining oral PrEP implementation in Uganda, South Africa, Kenya, and Zimbabwe. Findings revealed varied HCW awareness and knowledge, often influenced by prior exposure to pilot initiatives. Attitudes were generally positive, emphasizing PrEP’s potential to enhance adherence and reduce stigma. Reported barriers included limited training, inadequate infrastructure, increased workload, and the absence of clinical guidelines. Key facilitators included task-shifting, government commitment, targeted capacity-building, and peer-led learning. These oral PrEP implementation lessons directly inform the readiness of injectable PrEP rollout.ConclusionHealthcare workers in SSA display positive attitudes but uneven readiness to deliver PrEP. While most evidence derives from oral PrEP implementation, lessons learned on training needs, infrastructure requirements, task-shifting strategies, and health system readiness directly inform the introduction of injectable PrEP. Addressing gaps in training, guidelines, and resources, alongside strengthening policy and system support, is essential for the effective integration and scale-up of both oral and injectable PrEP formulations.
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