Urgent appeal to allow all professional nurses and midwives to prescribe pre-exposure prophylaxis (PrEP) in South Africa

Appeal to simplify PrEP provision in South Africa


  • D L Joseph Davey Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of Cape Town, South Africa; Division of Infectious Diseases, Geffen School of Medicine, University of California Los Angeles, USA; Desmond Tutu HIV Centre, University of Cape Town, South Africa
  • L Wilkinson Centre for Infectious Disease and Epidemiological Research, School of Public Health, Faculty of Health Sciences, University of Cape Town, South Africa; International AIDS Society, Johannesburg, South Africa
  • A Grimsrud International AIDS Society, Johannesburg, South Africa
  • A Nelson Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of Cape Town, South Africa
  • A Gray Discipline of Pharmaceutical Sciences, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
  • Y Raphael Advocacy for Prevention of HIV and AIDS, Johannesburg, South Africa
  • C Wattrus Southern African HIV Clinicians Society, Johannesburg, South Africa
  • Y Pillay Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
  • L-G Bekker Desmond Tutu HIV Centre, University of Cape Town, South Africa




PrEP, South Africa, Nurses, Pre-Exposure Prophylaxis, Medical training




Joint United Nations Programme on HIV/AIDS (UNAIDS). Global commitments, local action: After 40 years of AIDS, charting a course to end the pandemic. Geneva: UNAIDS, 2021. https://www.unaids. org/en/resources/documents/2021/global-commitments-local-action (accessed 5 May 2023).

Joint United Nations Programme on HIV/AIDS (UNAIDS). UNAIDS data 2020. Geneva: UNAIDS, 2021. https://www.unaids.org/en/resources/documents/2020/unaids-data (accessed 5 May 2023).

Haberer JE, Mujugira A, Mayer KH. The future of HIV pre-exposure prophylaxis adherence: Reducing

barriers and increasing opportunities. Lancet HIV 2023;10(6):e404-e411. https://doi.org/10.1016/


WoldesenbetSA,KufaT,LombardC,etal.The2017NationalAntenatalSentinelHIVSurveykeyfindings, South Africa. National Department of Health, 2019. https://doi.org/10.13140/RG.2.2.25252.01928

Beesham I, Heffron R, Evans S, et al. Exploring the use of oral pre-exposure prophylaxis (PrEP) among women from Durban, South Africa as part of the HIV prevention package in a clinical trial. AIDS Behav 2021;25(4):1112-1119. https://doi.org/10.1007/s10461-020-03072-0

Joseph Davey DL, Daniels J, Beard C, et al. Healthcare provider knowledge and attitudes about pre- exposure prophylaxis (PrEP) in pregnancy in Cape Town, South Africa. AIDS Care 2020;32(10):1290- 1294. https://doi.org/10.1080/09540121.2020.1782328

Hosek S, Celum C, Wilson CM, Kapogiannis B, Delany-Moretlwe S, Bekker LG. Preventing HIV among adolescents with oral PrEP: Observations and challenges in the United States and South Africa. J Int AIDS Soc 2016;19(7 Suppl 6):21107. https://doi.org/10.7448/IAS.19.7.21107

Celum CL, Delany-Moretlwe S, McConnell M, et al. Rethinking HIV prevention to prepare for oral PrEP implementation for young African women. J Int AIDS Soc 2015;18(4 Suppl 3):20227. https://doi. org/10.7448/IAS.18.4.20227

World Health Organization. Differentiated and simplified pre-exposure prophylaxis for HIV prevention: Update to WHO implementation guidance. Geneva: WHO, 2022. https://www.who.int/ publications/i/item/9789240053694 (accessed 12 September 2022).

South African National Department of Health. 2021 Updated guidelines for the provision of oral pre-exposure prophylaxis (PrEP) to persons at substantial risk of HIV infection. Pretoria: NDoH, 2021. https://knowledgehub.health.gov.za/elibrary/updated-guidelines-provision-oral-pre-exposure- prophylaxis-prep-persons-substantial-risk (accessed 5 May 2023).

Bekker LG, Brown B, Joseph-Davey D, et al. Southern African guidelines on the safe, easy and effective use of pre-exposure prophylaxis: 2020. South Afr J HIV Med 2020;21(1):1152. https://doi.org/10.4102/ sajhivmed.v21i1.1152

Schaefer R, Amparo da Costa Leite PH, Silva R, et al. Kidney function in tenofovir disoproxil fumarate-based oral pre-exposure prophylaxis users: A systematic review and meta-analysis of published literature and a multi-country meta-analysis of individual participant data. Lancet HIV 2022;9(4):e242-e253. https://doi.org/10.1016/S2352-3018(22)00004-2

Joseph Davey DL, Mvududu R, Mashele N, et al. Early pre-exposure prophylaxis (PrEP) initiation and continuation among pregnant and postpartum women in antenatal care in Cape Town, South Africa. J Int AIDS Soc 2022;25(2):e25866. https://doi.org/10.1002/jia2.25866

Stalter RM, Pintye J, Mugwanya KK. Safety review of tenofovir disoproxil fumarate/emtricitabine pre-exposure prophylaxis for pregnant women at risk of HIV infection. Expert Opin Drug Saf 2021;20(11):1367-1373. https://doi.org/10.1080/14740338.2021.1931680

Joseph Davey DL, Pintye J, Baeten JM, et al. Emerging evidence from a systematic review of safety of pre- exposure prophylaxis for pregnant and postpartum women: Where are we now and where are we heading? J Int AIDS Soc 2020;23(1):e25426. https://doi.org/10.1002/jia2.25426

Dettinger JC, Kinuthia J, Pintye J, et al. Perinatal outcomes following maternal pre-exposure prophylaxis (PrEP) use during pregnancy: Results from a large PrEP implementation program in Kenya. J Int AIDS Soc 2019;22(9):e25378. https://doi.org/10.1002/jia2.25378

Heffron R, Mugo N, Hong T, et al. Pregnancy outcomes and infant growth among babies with in utero exposure to tenofovir-based preexposure prophylaxis for HIV prevention. AIDS 2018;32(12):1707-1713. https://doi.org/10.1097/QAD.0000000000001867

Ndase P, Celum C, Campbell J, et al. Successful discontinuation of the placebo arm and provision of an effective HIV prevention product after a positive interim efficacy result: The Partners PrEP Study experience. J Acquir Immune Defic Syndr 2014;66(2):206-212. https://doi.org/10.1097/QAI.0000000000000141

Mugo NR, Hong T, Celum C, et al. Pregnancy incidence and outcomes among women receiving preexposure prophylaxis for HIV prevention: A randomized clinical trial. JAMA 2014;312(4):362-371. https://doi.org/10.1001/jama.2014.8735

Van Damme L, Corneli A, Ahmed K, et al. Preexposure prophylaxis for HIV infection among African women. N Engl J Med 2012;367(5):411-422. https://doi.org/10.1056/NEJMoa1202614

Anderson PL, Kiser JJ, Gardner EM, Rower JE, Meditz A, Grant RM. Pharmacological considerations for tenofovir and emtricitabine to prevent HIV infection. J Antimicrob Chemother 2011;66(2):240-250. https:// doi.org/10.1093/jac/dkq447







How to Cite

Joseph Davey DL, Wilkinson L, Grimsrud A, Nelson A, Gray A, Raphael Y, et al. Urgent appeal to allow all professional nurses and midwives to prescribe pre-exposure prophylaxis (PrEP) in South Africa: Appeal to simplify PrEP provision in South Africa. S Afr Med J [Internet]. 2023 Aug. 3 [cited 2024 Jun. 15];113(8):12-6. Available from: https://samajournals.co.za/index.php/samj/article/view/1121

Similar Articles

1-10 of 290

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)