A ground-breaking study conducted across all ten districts of Lesotho has identified hair salons as promising venues for expanding access to HIV and sexual and reproductive health (SRH) services for adolescent girls and young women.
The research, led by citizen scientists in collaboration with international partners, underscores the high feasibility and acceptability of delivering these vital health services in community-based, non-clinical settings.
Adolescent girls and young women in Lesotho continue to face a disproportionate burden of HIV and SRH-related challenges. Traditional health facilities often present structural and social barriers, creating an urgent need for more accessible, less medicalised service delivery options. The study explored the potential of hair salons to fill this gap.
Using an innovative mixed-methods approach, researchers recruited 157 hair stylists and 308 clients aged 15–35 via social media platforms. Hair stylists actively participated as citizen scientists by administering questionnaires and engaging in in-depth interviews alongside their clients. This participatory method ensured the study was shaped by the lived experiences of those it sought to serve.
The findings were overwhelmingly positive. A notable 93.6% of stylists reported feeling comfortable offering oral HIV self-testing (HIVST), while 92.4% were comfortable with pre-exposure prophylaxis (PrEP) and 91.7% with post-exposure prophylaxis (PEP). Clients reflected similar enthusiasm, with 93.5% expressing comfort with HIVST, 88.3% with PrEP, and 86.4% with PEP being offered in a salon setting.
Immediate demand was also encouraging, with 30.8% of clients expressing interest in HIVST, 22.1% in PrEP, and 14.9% in PEP.
Beyond the health impact, the study revealed strong economic incentives: 90.4% of stylists believed that offering HIV/SRH services would positively benefit their businesses. Salons were also found to be more accessible than nearby health facilities, both in terms of cost and convenience, with most clients visiting once or twice a month.
Qualitative data reinforced these findings, with clients describing salons as less judgmental and more welcoming than conventional clinics. However, the study also identified a few challenges. Chief among them was the need for confidential spaces, as only 21% of salons currently have a designated private area. Addressing such infrastructure gaps will be crucial to ensuring privacy and trust in future interventions.
“This study strongly suggests that integrating HIV/SRH services into hair salons in Lesotho is not only acceptable but also feasible with some targeted support. The high level of comfort among both stylists and clients, coupled with the existing accessibility of salons, presents a unique opportunity to reach young women who may otherwise face barriers to care,” stated the researchers.
The study’s conclusions underscored the potential of these vibrant community hubs as trusted points of contact for critical health information and services.
The research team now advocates for a pilot intervention to translate these promising findings into practical, impactful programs, ultimately contributing to improved HIV and SRH outcomes for young women in Lesotho.
Ntsoaki Motaung is an award-winning health journalist from Lesotho, specializing in community health stories with a focus on sexual and reproductive health and rights, as well as HIV. She has contributed to platforms like “Be in the KNOW,” highlighting issues such as the exclusion of people with disabilities from HIV prevention efforts in Lesotho.
In addition to her journalism, Ntsoaki serves as the Country Coordinator for the Regional Media Action Plan Support Network (REMAPSEN). She is also a 2023 CPHIA Journalism Fellow.
