A Scoping Review of Pre-Exposure Prophylaxis Uptake and Correlates Among Female University Students in Johannesburg, South Africa

Female university students in South Africa are a priority population for HIV prevention due to high incidence and vulnerability. Pre-exposure prophylaxis (PrEP) is an effective biomedical intervention, but its uptake among this group in high-burden settings like Johannesburg is not well synthesised. Understanding PrEP use and its determinants is needed to strengthen public health strategies. This scoping review aimed to map and synthesise evidence on PrEP uptake and its correlates among female university students in Johannesburg, South Africa. The objective was to identify factors influencing use and to highlight gaps in the literature. A scoping review was conducted following established frameworks. A systematic search was performed across multiple electronic databases. Peer-reviewed articles, reports, and dissertations were screened for eligibility. Data from included sources were charted and analysed thematically. The review identified a limited but growing body of literature. A prominent theme was the significant influence of perceived stigma and fear of being labelled as HIV-positive, which acted as a major barrier to PrEP initiation. Uptake remained low overall, with knowledge of PrEP not consistently translating into use. Other correlates included interpersonal influences, healthcare access issues, and concerns about side effects. PrEP uptake among female university students in Johannesburg is suboptimal, hindered by a complex interplay of social, structural, and individual factors. While knowledge is necessary, it is insufficient alone to drive adoption. The review underscores the need for tailored, multi-level interventions. Future research should employ longitudinal and intervention-based designs. Public health programmes must integrate stigma-reduction campaigns and youth-friendly PrEP services within and around university settings. Policy should support the normalisation of PrEP as a prevention tool. HIV prevention, pre-exposure prophylaxis, PrEP, university students, women, South Africa, scoping review. This review consolidates existing evidence on PrEP uptake and its correlates for a key population in Johannesburg, providing a foundation for future research and targeted programme development.