This study is being conducted in Buffalo City Metro (BCM) Health District, Eastern Cape Province, South Africa (Fig. (Fig.1).1). In 2016, BCM had an estimated mid-year population of 834,998 people. In 2016, the South African National Department of Health estimated that BCM had a general population HIV prevalence of 12.4% and incidence of 0.54%; an adult (15+ years old) HIV prevalence of 17.1% and incidence of 0.74%; and a female youth (age 15–24 years) HIV prevalence of 12.8% and incidence of 2.40% [41]. Within BCM, our study will be conducted in one urban and one rural community. Selection of study communities was conducted in consultation with the BCM Department of health and was informed by census data, absence of other ongoing HIV prevention studies, and community willingness to be involved in the study.

Provincial map of South Africa showing location of study communities within Buffalo City Metro Health District, Eastern Cape Province

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