Table 4

PrEP challenges^*

	Policymakers	Healthcare workers	NGOs
Peru	^†Risk compensation, effectiveness, side effects	^†Low educational level, cost-effectiveness, access to key groups	^†Stigma, religious and political barriers, access to key groups
	^‡Religious and political barriers, adherence, training providers and users	^‡Adherence, stigma, side effects	^‡Side effects, risk compensation, adherence
	^§Demand (lack or excess), access to key groups	^§Training providers and users, risk compensation	^§Resistance, government support
Ukraine	^†Cost-effectiveness, side effects, increase in STIs	^†Adherence, side effects, training providers	^†Government willingness, adherence, training providers
	^‡Adherence, access to key groups, black market	^‡Cost, supply, government support	^‡Side effects, HIV testing, cost
	^§Implementation, government support	^§Religious barriers, risk compensation	^§Resistance, black market
India	^†Efficacy, need for local trials, risk compensation	^†Risk compensation, stigma, lack of awareness	^†Risk compensation, efficacy, need for local trials
	^‡Users mistrust, adherence, supply	^‡Adherence, HIV testing, users' accessibility	^‡Supply, adherence, access to key groups
	^§Resistance, side effects	^§Resistance, side effects	^§Stigma, religious and political barriers
Kenya	^†Supply, programme complexity, HIV testing	^†Risk compensation, cost, adherence	^†Cost, training users, resistance
	^‡Resistance, limited ART coverage, HWs' workload	^‡Access to key groups, misconceptions and rumours, limited ART coverage	^‡Limited ART coverage, supply, adherence
	^§Black market, side effects	^§Supply, HWs' workload	^§Access to key groups, programme complexity
Uganda	^†Cost, limited ART coverage, adherence	^†Cost, limited ART coverage, resistance	^†Cost, limited ART coverage, user acceptability
	^‡Risk compensation, sustainability, government support	^‡Adherence, criminalisation and stigma, risk compensation	^‡Risk compensation, adherence, sustainability
	^§Information and training, HW training and workload	^§Side effects, information and training	^§Resistance, information and training
Botswana	^†Risk compensation, HIV status disclosure, side effects	^†Adherence, cost, resistance	^†Cost-effectiveness, risk compensation, implementation
	^‡Adherence, resistance, religious barriers	^‡Efficacy, increase in STIs, information and training	^‡Resistance, criminalisation and stigma, limited ART coverage
	^§Cost-effectiveness, long-term regimen	^§Risk compensation, HWs workload and levels	^§Adherence, side effects
South Africa	^†Cost-effectiveness, adherence, cost	^†Adherence, healthcare system overload, risk compensation	^†Risk compensation, adherence, cost
	^‡Sustainability, side effects, risk compensation	^‡Information and training, cost, limited ART coverage	^‡Government support, side effects, information and training
	^§Resistance, defining eligibility criteria	^§Side effects, effectiveness	^§Effectiveness, healthcare system overload

↵* In descending order from most important and recurrent.
↵† High priority.
↵‡ Medium priority.
↵§ Low priority.
ART, antiretroviral therapy; HWs, health workers; NGOs, non-governmental organisations; PrEP, pre-exposure prophylaxis; STI, sexually transmitted infection.