A survey-based exploratory study of factors influencing women’s intentions to utilise pre-exposure prophylaxis in the Eastern Cape Province, South Africa: sociodemographic characteristics, HIV risk behaviours and transactional sex

Background: South Africa has the third-highest adult prevalence rate globally, with women comprising 64% of cases. Despite the accessibility of pre-exposure prophylaxis (PrEP), its adoption among women, particularly young women, remains alarmingly low. Objectives: The objective of this initial investigation is to explore factors influencing the intentions of South African women to use PrEP, focusing on sociodemographic factors, HIV sexual risk behaviours and involvement in transactional sex. Design: The research utilised an exploratory design employing surveys. Methods: Surveys were conducted in 2015 with 64 women aged 19–49 residing in the Eastern Cape Province of South Africa. The data were analysed using descriptive statistics and multiple logistic regression. Data analysis was performed using SPSS 28.0 and R. Results: Younger women, compared to older women, were more inclined to intend to use PrEP ( p = 0.056, χ 2 = 3.655, df = 1, OR 0.92, CI (0.89, 0.99)). Women who used a condom were less likely to intend to use PrEP ( p = 0.082, χ 2 = 3.025, df = 1, OR 0.29, CI (0.09, 1.14)). Respondents who engaged in transactional sex were more inclined to intend to use PrEP ( p = 0.007, χ 2 = 7.330, df = 1, OR 6.86, CI (1.82, 31.0)). Conclusion: Addressing factors that impact South African women’s intentions to use PrEP is crucial for enhancing the adoption of PrEP among this population.