15–16 March 2025, Dar es Salaam, Tanzania

Community peers are an important bridge between HIV prevention services and the people who need them. Experiences from the #SwallowIt PrEP Demand Creation Campaign show that effective peer-led demand creation requires accurate information, stronger support systems and effective client follow-up. On 15–16 March 2025, community peers and peer navigators working on HIV prevention came together for a PrEP literacy and demand-creation engagement organized through a collaboration between Gabinet and Focus for the Future Generation with a technical assistance from CEA. The engagement sought to strengthen peers’ knowledge of PrEP, understand barriers affecting demand and continued use, identify solutions, and explore how community and social media networks could increase PrEP awareness. 

Learning from community experience

A questionnaire captured peers’ experiences of PrEP demand creation, including how they reached communities, challenges encountered and support needed.  Peers reported reaching prospective PrEP users through sexual networks, Facebook, Instagram, SMS, hotspots, dating applications, bars, home visits and other spaces where clients felt safe. Sexual networks were the most commonly reported approach. However, 29% reported having no defined demand-creation strategy, highlighting an opportunity to strengthen and better structure peer-led approaches. 

From creating to sustaining demand

The experiences also showed that getting people to start PrEP is only part of the challenge. Among respondents providing information on PrEP use and discontinuation, each peer managed an average of 41 PrEP users, with an average of 10 reported as having discontinued PrEP.  Reasons included relocation, myths and misconceptions, side effects, stigma, inadequate follow-up and difficulties responding to clients’ questions. Peers also encountered misconceptions that PrEP is intended for people living with HIV, damages kidneys, reduces immunity or causes infertility. These experiences demonstrate the importance of moving beyond creating demand to sustaining demand through continuous information and support.

Investing in community-led PrEP demand creation

Peers identified several priorities for strengthening their work, including continuous education on HIV and STI prevention, updated PrEP information, better client follow-up, improved remuneration, greater recognition of peer roles by communities and health facilities, and broader public education about PrEP. The engagement also explored digital amplification through #PrEP, #SwallowIt and #HIVPrevention, connecting face-to-face peer engagement with social media and online networks. The #SwallowIt experience reinforces an important lesson: community peers are not simply messengers; they are an essential part of the HIV prevention system.

As HIV prevention choices expand, investing in peer knowledge, networks, follow-up systems and digital tools will be critical. Successful PrEP demand creation is ultimately not just about ensuring people know PrEP exists. It is about enabling communities to understand it, trust it, access it and remain supported in making HIV prevention choices that work for them.