South Africa
A snapshot of PrEP scale-up, registration and resources for South Africa.

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527,000-528,000Estimated Cumulative Number of People Initiating PrEP
Aggregates numbers reported from demonstration projects, PEPFAR dashboard and program/country reports where available. This is presented as a range due to difficulty in tracking precise numbers and possible double reporting.
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224,905PEPFAR PrEP Target in COP 2022
Targets are set by PEPFAR country teams on an annual basis. Targets do not indicate funding is available for PrEP.
Drug Registration Status
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Gilead's Truvada (TDF/FTC) registrationApproved
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Generic versions of TDF/FTC for preventionApproved
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Viiv’s Apretude (CAB for PrEP) RegistrationUnder review
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IPM’s Dapivirine Ring RegistrationApproved
Types of Delivery Projects
- Behavioral and social science projects
- Clinical trials
- Demonstration projects — which road-test the use of new options in real-world settings—not in a trial site. They have a formal evaluation component that is designed to address specific elements of introduction such as infrastructure needs and ways individuals can integrate it into daily activities.
- Implementation projects
- Large-scale implementation initiative — funded/implementer involvement and investment in some or all steps related to comprehensive introduction that may or may not use government clinics as the primary service delivery point – e.g., Kenya’s Jilinde program.
- Open-label extension
- Product introduction and support projects
Policy Framework
- National launch of oral PrEP for sex workers in early 2016; click here for National Sex Worker HIV Plan (2016-2019)
- National Strategic Plan for HIV, TB and STIs 2017-2022
- National Policy on HIV PrEP and Test and Treat (2016)
- South African Guidelines for the Provision of Pre-exposure Prophylaxis (PrEP) to Persons at Substantial Risk of HIV Infection (2020)
Funding
- NIAID
- NIMH
- NICHD
- USAID
- The Bill & Melinda Gates Foundation
- PEPFAR
- NIH
- UNITAID
- Anova Health Institute
- Desmond Tutu HIV Foundation
- Elton John AIDS Foundation
- CAPRISA
- DAIDS
- IMPAACT Network
- MSF
- MTN
- IPM
- Nike Foundation
- Wits RHI
- London School of Hygiene & Tropical Medicine
Selected Technical & Strategic Assistance
- OPTIONS / Wits RHI
- Prevention Market Manager
Eligibility Criteria
PrEP should be considered for people who are HIV-negative and at significant risk of acquiring HIV infection. PrEP may be suitable for:
Any sexually active HIV-negative MSM or transgender person who wants PrEP
- those with HIV-positive sexual partner(s) who are not confirmed virologically suppressed
- partner(s) of unknown HIV status
- recent STI
- multiple sexual partners
- history of inconsistent or no condom use
- commercial sex work
- recurrent PEP users
- history of sex whilst under the influence of alcohol or recreational drugs
Heterosexual women and men who want PrEP, targeting especially
- those with HIV-positive sexual partner(s) who are not confirmed virologically suppressed
- partner(s) of unknown HIV status
- recent STI
- multiple sexual partners
- history of inconsistent or no condom use
- commercial sex work
- serodiscordant couples trying to conceive
- recurrent PEP users
- history of sex whilst under the influence of alcohol or recreational drugs
people who inject drugs
- HIV-negative PWID with HIV-positive/unknown status injecting partner(s)
- share injecting needles and drug preparation equipment
All of the above groups include adolescents and sex workers, which each constitute special groups meriting specific consideration
- especially vulnerable are young MSM and adolescent girls
Resources for South Africa
- Stakeholder Conversations to Inform Delivery of New HIV Prevention Methods in South Africa
- HIV Prevention Ambassador Training: Interactive virtual oral PrEP sessions
- OPTIONS Technical Brief — Oral PrEP Youth Dialogues: What AGYW really think about PrEP, HIV services and how we talk to them!
- Breaking the Cycle of Transmission — A human-centered approach for improving pathways to HIV testing and linkage to treatment among young people in South Africa
- Dapivirine Ring Early Introduction Considerations: South Africa analysis — The OPTIONS Consortium conducted secondary research and interviews with key stakeholders in several countries to understand questions about the ring that could inform demonstration and processes for introducing new biomedical HIV prevention products.
- HIV Prevention Research and Demonstration Sites in South Africa
- Landscape Analysis of Oral PrEP for Adolescent Girls and Young Women in South Africa
- Oral PrEP Private Sector Landscape Analysis
- Oral PrEP Situation Analysis for South Africa
- Poster Presentation – Mapping the Knowledge and Gaps in the Adolescent Girls and Young Women PrEP Implementation Projects and Trials in South Africa
- Interactive Timeline for the Introduction of Oral PrEP in South Africa
- Early Lessons from Oral PrEP Rollout to Sex Workers in South Africa
- A Framework for Scaling Up PrEP can help implementers, government and advocates begin planning for and implementing PrEP programs.
- Click here for the latest information from the South African Ministry of Health.
- PrEP4Youth — The OPTIONS Consortium, in collaboration with the National Department of Health, created five short, powerful videos that encourage PrEP as an acceptable HIV prevention method for adolescent girls and young women.
South Africa Job Aids
These South Africa-specific job aids were created to support health care workers, peer educators, and counselors at oral PrEP rollout sites. The adherence counseling guide and checklist aim to assist counselors and health care workers with discussing oral PrEP initiation and adherence. “The Road to PrEP” poster details, in visual format, the steps required to refer HIV-positive clients for immediate test and treat, as well as the counseling and oral PrEP initiation for HIV-negative clients. Finally, the palm card educates the potential user about oral PrEP.
- PrEP Adherence Counselling Triangle
- PrEP Counselling Poster
- PrEP Palm Card
- Quick Guide PrEP Checklist
For South Africa specific information, education and communication materials, visit this page.