Background: The national policy on oral pre-exposure prophylaxis (PrEP) for female sex workers (FSWs) was instituted in South Africa in 2016. FSWs were targeted for PrEP due to a Human immunodeficiency virus (HIV) prevalence of 57.7%, which is higher than the prevalence of 19.07% among the general population. Research from demonstration studies has shown that uptake of PrEP has been slower than anticipated, and the purpose of this study was to explore barriers to the uptake of PrEP among FSWs.Methods: An in-depth qualitative study was conducted with 39 participants, 30 individual participants, and nine focus group participants. Eleven participants consisted of peer educators and two health workers from a sex work and PrEP distribution organization, the rest of the participants (1) were FSWs.Results: The majority of participants mentioned that little distinction was made between PrEP and antiretrovirals (ARVs) taken by FSWs living with HIV. PrEP was not distributed through public health care facilities, and health workers unknowingly labeled PrEP as ARVs. Consequently, health workers seen as experts created suspicion and contributed to the mistrust of PrEP among FSWs due to mixed messages, and equating PrEP to ARVs reduced uptake. Furthermore, failure to make a clear distinction between oral PrEP and ARVs resulted in accusations of lying, denialism, and deception leveled at users of PrEP by FSWs using ARVs, and sometimes by clients and intimate partners. FSWs using PrEP reported feeling stigmatized and thrust into interpersonal conflict with their peers after choosing PrEP, leading to broken relationships, and some resorting to taking PrEP privately or discontinuing PrEP altogether.Conclusion: Pre-exposure prophylaxis as an ARV targeted for the prevention of HIV among high-risk groups was found to be stigmatizing. The distinctive use of PrEP and ARVs should be correctly explained to users to minimize confusion, enable differentiation and reduce interpersonal conflict. Cohesion among sex work organizations and public health care facilities is needed to disseminate the correct knowledge on PrEP. A non-stigmatizing approach to the distribution of PrEP may serve to increase uptake and adherence.

Background: Globally, female sex workers (FSWs) are considered a key population group due to the high HIV prevalence. Studies show that there are various factors in some contexts that render FSWs marginalised, which limits their access to sexual reproductive health (SRH) services. Access to SRH services are particularly challenging in countries where sex work is criminalised such as is the case in South Africa. Evidently, there are alternative ways in which FSWs in this context receive non-stigmatising SRH care through non-governmental organisations. The aim of this study was to understand the functioning of these non-governmental health care services as well as to document the experiences of FSWs utilising these services. Methods: Eleven focus group discussions were held with 91 FSWs. In addition, 21 in-depth individual interviews with researchers, stakeholders and FSWs were conducted. Interview guides were utilised for data collection. Informed consent was obtained from all participants. Data were analysed thematically. Results: The FSWs expressed challenges related to SRH care access at public health facilities. The majority felt that they could not consult for SRH-related services because of stigma. The non-governmental health and advocacy organisations providing SRH services to FSWs through their mobile facilities utilising the peer approach, have done so in a way that promotes trust between FSWs and mobile health care providers. FSWs have access to tailored services, prevention materials as well as health information. This has resulted in the normalising of HIV testing as well as SRH seeking behaviours. Conclusion: This study has established that health and advocacy organisations have attempted to fill the gap in responding to SRH care needs of FSWs amidst intersecting vulnerabilities. FSWs’ engagement with these organisations has encouraged their willingness to test for HIV. However, it is important to note that these organisations operate in urban areas, thus FSWs operating outside these areas are most likely exposed to compounding health risks and lack access to tailored services.

School violence is a prevalent phenomenon across Southern African Development Community (SADC), affecting children’s psychosocial and mental well-being. As part of SADC’s educational goals, access to quality education is a priority and is beneficial for the region’s economic growth and development. This goal cannot be achieved without addressing school violence at its roots. Using Arksey and O’Malley’s five-step framework, this scoping review explored evidence of contextual factors that contribute to school violence in the region. Twenty-four articles were included, and six themes were identified: home contextual factors, parental factors, community risk factors, school contextual factors, sociability factors, and demographic and individual characteristics. The findings suggest that factors contributing to school violence were from the learners’ immediate environments, including exposure to violence at home and poor parental methods, interactions with teachers and lack of appropriate disciplinary methods and processes, disruptive ideas related to masculinity, lack of understanding and intolerance to demographic and individual differences, and exposure to violence, drugs, and alcohol at the community level. To address this phenomenon, a comprehensive approach is needed, which includes developing clear school policies, teacher training on managing disruptive behaviours and professionalism, mapping incidents of school violence, and interventions involving collaboration between schools, parents, and school social workers to curb school violence.

To explore the motivating factors that encourage female sex workers to take oral PrEP, despite the challenges that come with adherence. The 39 participants in this study consisted of female sex workers, peer educators, a counselor, and a researcher. Participants took PrEP as an expression of self-love. Some participants described PrEP as empowering because they could independently prevent HIV. They were also motivated by parenting, hope and future aspirations. It is important for future PrEP interventions to incorporate behavioral strategies that appeal to the user’s personal and deeper motivations for living.

Female sex workers (FSWs) in South Africa have a high HIV prevalence. To reduce the rate of new infections, pre-exposure prophylaxis (PrEP) was introduced to FSWs; however, studies show that FSWs’ uptake and adherence to PrEP has been inconsistent. This study explored existing evidence related to strategies used to encourage PrEP uptake and adherence. Utilizing the scoping review framework, seven peer-reviewed articles were analyzed thematically. The themes were (1) PrEP promotion and distribution, (2) PrEP counselling and using educational resources, and (3) using instant messaging and rewards programs. The suggestions from the literature include a generalized PrEP promotion and distribution approach not aimed towards high-risk groups to avoid stigma. PrEP pick-up points should include sex work-friendly healthcare facilities as well as community-based venues. PrEP counselling should be conducted prior to PrEP administration to prepare users on how to deal with side effects. Information, education, and communication materials should be colorful and consist of catchy phrases targeted to the whole population. Instant messaging has been found to be effective in encouraging adherence. FSWs should be instrumental in informing intervention best practices. Future interventions aimed at FSWs should focus on holistic wellness that incorporates the psychosocial aspects of HIV prevention.

Access to quality education, as per the Southern African Development Community’s (SADC) vision is essential for improving the overall economic growth and development of the region. However, this vision is severely hindered by school violence, a pervasive contextual issue across multiple SADC countries. Guided by Arksey and O’Malley’s five-step framework, this proposed scoping review sought to explore the contextual factors that contribute to school violence and examine intervention strategies that have been used to mitigate school violence. Six databases will be used to search for empirical articles, including ProQuest, PubMed, Web of Science, Academic Search Ultimate, PsycINFO and MEDLINE Ultimate. Screening at the abstract, title and full-text level will be conducted by all authors, with further articles being searched on the research list of the final included full-text publications. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) will be used to report on the scoping review processes. It is hoped that this scoping review will contribute to the overall understanding of the contextual factors that contribute to school violence in the context of SADC and the intervention strategies used to curb this phenomenon. The scoping review will also identify gaps in knowledge in literature and gaps in the current intervention practices, as well as influence future research on school violence in the SADC region. Keywords: School Violence, Southern African Development Community, Contextual Factors, Intervention.