A pilot cluster randomized controlled trial assessing uptake of PrEP and contraception in hair salons in South Africa
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 contra...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-02-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-025-21718-3 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823861573386502144 |
|---|---|
| author | Ingrid V. Bassett Joyce Yan Sabina Govere Sthabile Shezi Lungile M. Ngcobo Shruti Sagar Jana Jarolimova Dani Zionts Anele Khumalo Zinhle Zwane Christina Psaros Nduduzo Dube Robert A. Parker |
| author_facet | Ingrid V. Bassett Joyce Yan Sabina Govere Sthabile Shezi Lungile M. Ngcobo Shruti Sagar Jana Jarolimova Dani Zionts Anele Khumalo Zinhle Zwane Christina Psaros Nduduzo Dube Robert A. Parker |
| author_sort | Ingrid V. Bassett |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-84afa9af33e845379952beda8cb05dc0 |
| institution | Kabale University |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-84afa9af33e845379952beda8cb05dc02025-02-09T12:57:52ZengBMCBMC Public Health1471-24582025-02-0125111110.1186/s12889-025-21718-3A pilot cluster randomized controlled trial assessing uptake of PrEP and contraception in hair salons in South AfricaIngrid V. Bassett0Joyce Yan1Sabina Govere2Sthabile Shezi3Lungile M. Ngcobo4Shruti Sagar5Jana Jarolimova6Dani Zionts7Anele Khumalo8Zinhle Zwane9Christina Psaros10Nduduzo Dube11Robert A. Parker12Division of Infectious Diseases, Massachusetts General HospitalBiostatistics Center, Massachusetts General HospitalAIDS Healthcare FoundationAIDS Healthcare FoundationAIDS Healthcare FoundationMedical Practice Evaluation Center, Massachusetts General HospitalDivision of Infectious Diseases, Massachusetts General HospitalMedical Practice Evaluation Center, Massachusetts General HospitalAIDS Healthcare FoundationAIDS Healthcare FoundationHarvard Medical SchoolAIDS Healthcare FoundationCenter for AIDS Research (CFAR), Harvard UniversityAbstract 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.https://doi.org/10.1186/s12889-025-21718-3Pre-exposure prophylaxisCommunity health servicesSexually transmitted diseasesContraceptionSouth Africa |
| spellingShingle | Ingrid V. Bassett Joyce Yan Sabina Govere Sthabile Shezi Lungile M. Ngcobo Shruti Sagar Jana Jarolimova Dani Zionts Anele Khumalo Zinhle Zwane Christina Psaros Nduduzo Dube Robert A. Parker A pilot cluster randomized controlled trial assessing uptake of PrEP and contraception in hair salons in South Africa BMC Public Health Pre-exposure prophylaxis Community health services Sexually transmitted diseases Contraception South Africa |
| title | A pilot cluster randomized controlled trial assessing uptake of PrEP and contraception in hair salons in South Africa |
| title_full | A pilot cluster randomized controlled trial assessing uptake of PrEP and contraception in hair salons in South Africa |
| title_fullStr | A pilot cluster randomized controlled trial assessing uptake of PrEP and contraception in hair salons in South Africa |
| title_full_unstemmed | A pilot cluster randomized controlled trial assessing uptake of PrEP and contraception in hair salons in South Africa |
| title_short | A pilot cluster randomized controlled trial assessing uptake of PrEP and contraception in hair salons in South Africa |
| title_sort | pilot cluster randomized controlled trial assessing uptake of prep and contraception in hair salons in south africa |
| topic | Pre-exposure prophylaxis Community health services Sexually transmitted diseases Contraception South Africa |
| url | https://doi.org/10.1186/s12889-025-21718-3 |
| work_keys_str_mv | AT ingridvbassett apilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT joyceyan apilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT sabinagovere apilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT sthabileshezi apilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT lungilemngcobo apilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT shrutisagar apilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT janajarolimova apilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT danizionts apilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT anelekhumalo apilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT zinhlezwane apilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT christinapsaros apilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT nduduzodube apilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT robertaparker apilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT ingridvbassett pilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT joyceyan pilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT sabinagovere pilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT sthabileshezi pilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT lungilemngcobo pilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT shrutisagar pilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT janajarolimova pilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT danizionts pilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT anelekhumalo pilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT zinhlezwane pilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT christinapsaros pilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT nduduzodube pilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica AT robertaparker pilotclusterrandomizedcontrolledtrialassessinguptakeofprepandcontraceptioninhairsalonsinsouthafrica |