Uptake and Continuisation of the Progesterone-Containing Vaginal Ring for HIV Prevention Among Young Women in High-Incidence Communities of KwaZulu-Natal: A Cross-Sectional Survey, 2002

Young women in sub-Saharan Africa, particularly in high HIV incidence settings such as KwaZulu-Natal, bear a disproportionate burden of new infections. The progesterone-containing vaginal ring is a female-controlled HIV prevention option, but data on its real-world uptake and sustained use in these communities are limited. This study aimed to assess the uptake and continuation rates of the progesterone-containing vaginal ring for HIV prevention among young women in high-incidence communities of KwaZulu-Natal, South Africa. A cross-sectional survey was conducted among sexually active young women recruited from community-based settings. Participants completed a structured questionnaire capturing demographic data, sexual behaviour, knowledge of HIV prevention methods, and specific use patterns of the vaginal ring. Data were analysed using descriptive statistics. Uptake of the vaginal ring among the surveyed population was modest. Of those who had initiated use, a substantial proportion discontinued within the first few months. Key reported barriers included side effects, partner objections, and difficulties with insertion. Only a minority of initiators reported consistent use over a longer period. The findings indicate suboptimal uptake and continuation of the progesterone-containing vaginal ring in this population, highlighting a gap between method availability and effective, sustained utilisation. Programmes must integrate comprehensive counselling addressing side-effect management and partner communication. Further qualitative research is needed to understand the contextual and social barriers to continuation to inform the design of more effective implementation support. HIV prevention, vaginal ring, pre-exposure prophylaxis, continuation, adherence, young women, South Africa This study provides early community-level data on the use dynamics of a novel HIV prevention technology among a key demographic in a high-burden region, informing future implementation strategies.