A qualitative assessment of the factors influencing demand for PrEP among female college students in Durban, South Africa

BackgroundYoung women in South Africa experience a disproportionate burden of HIV transmission. Oral pre-exposure prophylaxis (PrEP) offers an additional HIV prevention option; however, its acceptability and use among young, female university students remain underexplored.MethodsThis qualitative study explored perceptions, awareness, and acceptability of oral PrEP among female university students in Durban, South Africa. Semi-structured, in-depth interviews were conducted with 12 female students aged 18-24 years. Data were thematically analysed to identify key factors shaping PrEP awareness, attitudes, and perceived barriers and facilitators to use.ResultsParticipants demonstrated varying levels of awareness of PrEP, often informed by informal sources such as peers, social media, and healthcare encounters. While PrEP was viewed as a potentially empowering HIV prevention option, misconceptions, fear of side effects, stigma associated with HIV-related medication, and concerns about partner reactions constrained acceptability and uptake. Structural barriers, including limited access to youth-friendly services, further influenced interest in PrEP.ConclusionThe findings highlight the complex social and structural contexts shaping PrEP acceptability among female university students and point to the need for targeted, youth-friendly communication and service delivery approaches.