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University of Botswana (UB) Faculty of Health Sciences Acting Deputy Dean, Professor Nthabiseng Phaladze, has warned that the low uptake of Pre-Exposure Prophylaxis (PrEP) in Botswana posed a significant risk of rising new HIV infections. Professor Phaladze made the remarks on the 25th of July 2025 during a stakeholder meeting held at the Centre for Continuing Education (CCE) to evaluate implementation strategies for the GenPopPrEP study which focuses on Pre-Exposure Prophylaxis (PrEP) uptake among the general population in Botswana.

The purpose of the meeting was to share the study pre-pilot preliminary findings, engage in meaningful dialogue about the study goals and most importantly gather insights and feedback to inform study strategies that could improve accessibility and effectiveness of PrEP service in communities across Botswana. Furthermore, Professor Phaladze noted that low PrEP uptake hindered progress towards achieving global HIV prevention targets and reducing the overall burden of the disease.

She said comprehensive and targeted awareness campaigns were crucial to educate individuals about PrEP and its benefits. She further highlighted that lower uptake of PrEP could be exacerbated by factors such as lack of awareness, perceived risk, fear of side effects, stigma and access barriers.

Ministry of Health PrEP Coordinator, Mrs Banyana Piet, indicated that the ministry was faced with several challenges in CAB-LA uptake including low eligibility and demand, poor retention, inequitable programme preference, shortage of reagents, attitudes of healthcare providers and lower reporting. Highlighting on the strategies to improve PrEP uptake, Mrs Piet said the ministry focused on increasing awareness, addressing stigma, simplifying access, providing tailored support and integrating PrEP services with other health initiatives. 

The study behavioural scientist, Ms Keonayang Kgotlaetsile, shared that preliminary pre-pilot results indicated that while stigma towards PrEP use was generally low, findings still suggested a perceived need to conceal PrEP use. Findings highlighted positive attitudes toward PrEP, citing benefits for personal health protection and reducing anxiety about HIV. Trust in health care providers and clinics emerged as a key factor for obtaining PrEP information, with primary care providers preferred for initial prescriptions. Among proposed delivery strategies, adherence buddies and community-based distribution were viewed most favourably whereas telehealth and postal delivery options received comparatively lower support.