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Randomized Controlled Trial
. 2025 Feb 8;25(1):524.
doi: 10.1186/s12889-025-21718-3.

A pilot cluster randomized controlled trial assessing uptake of PrEP and contraception in hair salons in South Africa

Ingrid V Bassett  1   2   3   4   5 , Joyce Yan  6 , Sabina Govere  7 , Sthabile Shezi  7 , Lungile M Ngcobo  7 , Shruti Sagar  8 , Jana Jarolimova  9   8   10 , Dani Zionts  8 , Anele Khumalo  7 , Zinhle Zwane  7 , Christina Psaros  10   11 , Nduduzo Dube  7 , Robert A Parker  12   10   6
Affiliations
Randomized Controlled Trial

A pilot cluster randomized controlled trial assessing uptake of PrEP and contraception in hair salons in South Africa

Ingrid V Bassett et al. BMC Public Health. .

Abstract

Background: Women in South Africa have a high burden of HIV infections, STIs, and unintended pregnancies. Women congregate regularly in hair salons, which may be useful venues for HIV and sexual and reproductive health (SRH) services. Our objective was to assess the uptake of PrEP and contraception in hair salons in South Africa.

Methods: We conducted a pilot cluster randomized controlled trial to evaluate uptake of a hair stylist-initiated, nurse-supported intervention offering a dynamic choice of contraception (oral or injectable), STI testing and treatment, and oral PrEP in 3 salons in urban KwaZulu-Natal. Rapid HIV testing was performed in a private area at enrollment and each PrEP dispensing. Women could receive contraception and/or oral PrEP at the initial visit or opt in at a later visit. We defined uptake as the proportion of eligible women who accepted salon-based PrEP and/or salon-based contraception at any visit. Control salon participants completed surveys and were referred to clinic. We assessed predictors of PrEP uptake among intervention participants using univariate logistic regression and multivariable logistic regression with age and potential predictors from the univariate analyses.

Results: Among 134 participants in intervention salons, the median age was 26 years (IQR 22-29). 75% reported visiting the salon at least every 2 months. 27% were using hormonal contraception at enrollment, 31% reported a self-perceived moderate or great chance of getting HIV in the next year, 33% thought their primary sex partner had other partners, 65% did not use condoms in the past month, and 11% reported intimate partner violence (IPV). About half (49%) accepted salon-based PrEP, and 89% accepted salon-based contraception during the study. Adjusting for age, uptake of salon-based PrEP was associated with experiencing IPV (aOR 4.20, 95%CI: 1.02, 17.36).

Conclusions: When offering a dynamic choice of integrated SRH services in urban hair salons in South Africa, we reached young women with risk factors for HIV, STIs, and unintended pregnancies. Hair salons are a novel venue for reaching young women who may not perceive themselves at risk for HIV, STIs, and unintended pregnancies.

Trial registration: Clinicaltrials.gov identifier: NCT04222504. Registered 01-08-2020.

Keywords: Community health services; Contraception; Pre-exposure prophylaxis; Sexually transmitted diseases; South Africa.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was conducted according to all guidelines within the Declaration of Helsinki. Ethical approval was obtained from the University of KwaZulu-Natal Biomedical Ethics Research Committee (Protocol No. BFC449/19) and the Mass General Brigham Institutional Review Board (Protocol No. 2019P003869). Written informed consent to participate was obtained from all study participants. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
CONSORT diagram for study enrollment in control and intervention arm
See this image and copyright information in PMC

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References

    1. UNAIDS. Epidemic & Response: South Africa. AIDSInfo 2023. https://aidsinfo.unaids.org/ (accessed December 4, 2024).
    1. Adeniyi OV, Ajayi AI, Moyaki MG, Goon DT, Avramovic G, Lambert J. High rate of unplanned pregnancy in the context of Integrated Family Planning and HIV Care Services in South Africa. BMC Health Serv Res. 2018;18:140. 10.1186/s12913-018-2942-z. - PMC - PubMed
    1. Jarolimova J, Chidumwa G, Chimbindi N, Okesola N, Dreyer J, Smit T, et al. Prevalence of Curable sexually transmitted infections in a Population-Representative Sample of Young adults in a high HIV incidence area in South Africa. Sex Transm Dis. 2023;50:796–803. 10.1097/OLQ.0000000000001871. - PMC - PubMed
    1. World Health Organization. Differentiated and simplified pre-exposure Prophylaxis for HIV Prevention: update to who implementation Guidance. World Health Organ. 2022. https://www.who.int/publications-detail-redirect/9789240053694. accessed July 13, 2023.
    1. Milford C, Scorgie F, Rambally Greener L, Mabude Z, Beksinska M, Harrison A, et al. Developing a model for Integrating Sexual and Reproductive Health Services with HIV Prevention and Care in KwaZulu-Natal, South Africa. Reprod Health. 2018;15:189. 10.1186/s12978-018-0633-1. - PMC - PubMed

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