Project PrEP

Project PrEP: Integrating PrEP Choice into comprehensive sexual and reproductive health services in South Africa, while expanding equitable access to and affordability of long-acting HIV prevention for the region.

Rationale

Project PrEP is a Unitaid-funded implementation science initiative that began in 2018, aimed at integrating oral PrEP into comprehensive sexual and reproductive health (SRH) services for adolescent girls and young women (AGYW). The project operates across fixed and mobile service platforms in Tshwane, Mthatha, Gqeberha, and eThekwini, South Africa.

The project uses a cluster model comprising primary healthcare facilities and mobile clinics to improve geographic and service accessibility for AGYW in high-priority communities. The Eastern Cape sites (Mthatha and Gqeberha) are being phased out by June 2026, while implementation continues in Tshwane and eThekwini, with ongoing service delivery and research activities, including the Len4PrEP study in Tshwane, which will continue into 2027.

Since 2022, the project has expanded from oral PrEP delivery to a multi-method HIV prevention platform, incorporating the Dapivirine Vaginal Ring (DVR), cabotegravir long-acting injectable (CAB-LA), and, in 2026, expanding to Lenacapavir (LEN) within implementation studies and early introduction work. This reflects a strategic shift from single-product delivery to PrEP choice within differentiated, client-centred HIV prevention services, including decentralised delivery, self-care approaches, and digital health integration.

In addition to generating real-world evidence on the delivery of PrEP choice, Project PrEP spearheads critical market-shaping efforts to ensure the affordability, access, and introduction of new PrEP technologies. In partnership with the Clinton Health Access Initiative (CHAI), Project PrEP supports country preparedness for LEN introduction in early adopter countries [read more here], while working with Dr Reddy’s Laboratories (DRL) to secure generic access to HIV prevention products for low- and middle-income countries. Project activities will be implemented until December 2027.

Primary Objectives

• Expand PrEP access and choice: Increase uptake of oral PrEP, DVR, CAB-LA, and LEN within integrated SRH services.
• Decentralised delivery: Strengthen community-based, mobile, and alternative service delivery models.
• Service integration: Improve STI, contraception, mental health, and GBV service integration within PrEP delivery.
• Evidence generation: Produce real-world data on PrEP choice, continuation, and differentiated service delivery models.
• Market shaping: Support affordability and availability of new PrEP technologies through supply- and demand-side interventions, global partnerships, technical assistance, and capacity strengthening to enable country readiness, introduction, and scale-up of emerging PrEP options.
• Demand generation: Strengthen community engagement and digital platforms to support informed PrEP choice.

Key Features

• Multi-channel demand generation (community, peer-led, and digital platforms)
• Integrated SRH and HIV prevention services
• Decentralised service delivery (mobile clinics, CBOs, pharmacies, and outreach points)
• Real-time digital engagement through chatbot and social media ecosystems
• Client-centred PrEP choice model across multiple biomedical options
• Technical assistance and capacity-strengthening support to Ministries of Health in early adopter countries, including guideline development, demand generation strategy, and implementation support for PrEP scale-up
• Strong linkage between implementation, research, and national policy support

Project Contribution

Project PrEP provides a scalable, real-world model for integrating multiple PrEP options into routine SRH services. Through decentralised delivery, digital innovation, and the introduction of new HIV prevention technologies, the project continues to generate evidence and implementation pathways that inform national and regional HIV prevention policy and scale-up.

Investigators

• Prof Saiqa Mullick – Principal Investigator
• Dr Catherine Martin – Co-Investigator
• Vusile Butler – Co-Investigator

Partners

Clinton Health Access Initiative

Latest Update

May 2026

For more about Project PrEP please email rhicomms@wrhi.ac.za

Click here for further details regarding the Project PrEP.