Pre-exposure Prophylaxis (PrEP) Training for Clinical Associates in South Africa


PrEP is a prevention intervention for individuals at very high risk of contracting HIV that includes daily doses of medications that can stop HIV from taking hold and spreading throughout the body if used consistently and as prescribed. According to the U.S. Centers for Disease Control and Prevention (CDC), daily PrEP reduces the risk of sexual transmission of HIV by more than 90 percent – a success rate that increases further when combined with the use of condoms and other prevention methods. Among people who inject drugs, PrEP reduces the risk by more than 70 percent. 

South Africa was the first country after the United States to approve PrEP as part of an overall combination HIV prevention strategy, but it has only been introduced in a limited number of sites, including pilot sites that provide services for key populations, such as female sex workers (FSWs) and men who have sex with men (MSM).

This project built on AIHA’s 13 years of experience implementing HIV interventions in South Africa, including eight years of broad-based experience supporting the training, deployment, and ongoing professional development of Clinical Associates. 

With a strong focus on developing a locally-driven and sustainable approach to the roll-out of PrEP – including increasing public awareness of the availability and benefits of PrEP – AIHA empowered Clinical Associates to train additional health workers on how to more effectively implement PrEP across many facility and community-based settings throughout South Africa. AIHA helped develop the new professional cadre of Clinical Associates during its PEPFAR supported Twinning Center Project.

Program Successes

With support from Gilead Sciences pharmaceutical company, AIHA collaborated with the South Africa-based Foundation for Professional Development (FPD) and Professional Association of Clinical Associates of South Africa (PACASA) to roll out PrEP to target populations via AIHA-trained Clinical Associates.

The development of a customized study material adjusted to the scope and needs of Clinical Associates in South Africa was crucial to the success of the pilot workshop and ultimately the launch of the online course. Having workshops to pilot the material, provided crucial feedback from participants at ground level in the immediate and future implementation of PrEP by CAs. 

PACASA members indicated that the customization of the study material for CAs opened the door for future endeavors that relate to skills building for Clinical Associates. The material was pitched at a level that was appropriate for CAs. This could pave the way for other skills building topics specifically addressed for the cadre of CAs.

Many of the participants described an increase in their confidence when it comes to discussing PrEP with their clients. The visual aids and other resources provided enabled them to educate illiterate clients – something that they found challenging before the training. The participants reported a high level of satisfaction with the online course, demonstrated by the high average ratings for the different course components (course material, video tuition, and assessments) and the support that was provided.

To read the final report on this project, click here.