Empowering women at risk: exploring the impact of accountability partners and whatsapp groups on PrEP utilization in Soweto, South Africa

Background: Globally, HIV remains a significant concern, particularly for high-risk populations. Pre-Exposure Prophylaxis (PrEP) has emerged as a promising method for HIV prevention, but understanding the factors influencing its uptake and retention is crucial. This study focuses on investigating how accountability partners and WhatsApp groups influence PrEP use among women at risk in Soweto, South Africa, aiming to empower them in their efforts to prevent HIV transmission. Methodology: The study design involved a venue-based intercept survey with data collected from 416 women at risk in Soweto. Utilizing REDCap, data were gathered from locations frequented by women at risk. Descriptive statistics, bivariate analysis, and logistic regression models were employed to assess the influence of accountability partners and social media groups on PrEP uptake and continuation. Results: The median age of the participants was 23 years, and factors influencing PrEP initiation and continuation were explored. Multiple sexual partners were significantly associated with both initiation and continuation (p < 0.001) with the likelihood of initiation and continuation being OR: 3.67 and OR: 1.13 respectively. Friends’ influence and the feeling of being at risk played a significant role in both stages (p < 0.001). Participation in WhatsApp groups discussing PrEP and health-related topics was significant for initiation, while general WhatsApp groups were associated with continuation. Partner refusal to use condoms was highly associated with higher reported rates of initiation and continuation of PrEP (OR: 3.67 and 5.93) respectively. Conclusions: The study highlights the crucial role of accountability partners and WhatsApp-based social groups in shaping PrEP utilization among high-risk populations. Findings underscore the potential for targeted public health strategies to enhance PrEP awareness, uptake, and continuation, contributing to the prevention of HIV spread in these communities.