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Adolescent girls and young women in southern Africa and particularly South Africa currently constitute the population most vulnerable to HIV infection. Many social factors contribute to this risk, among them widespread gender inequalities and the high prevalence of intimate partner and other forms of violence. Oral pre-exposure prophylaxis (PrEP) offers an effective new HIV prevention tool that women could potentially control. WHO has recommended PrEP as part of a combination HIV prevention package for people at substantial risk of HIV infection, and this provides a new opportunity to put HIV prevention in the hands of young women themselves. It also provides an opportunity to consider how best to respond to those structural factors that may ultimately influence the success of a biomedical HIV prevention method.
Wits RHI, as a STRIVE partner and a participant in several PrEP trials, has leveraged its unique position and knowledge of both structural and biomedical HIV prevention interventions to influence and shape the national combination prevention programme for girls and young women in South Africa (‘She Conquers’), which includes increasing access to PrEP.