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Background: Over the years, the South African government has emphasised improving the metros' socioeconomic infrastructures because these form an essential catalyst that can boost grassroots development. Despite the considerable increase in investments in transport infrastructure in the metros, the contributions of the metros where all these transport investments are concentrated appear to be making little use of it to promote their grassroots development. Objectives: The study investigated the impact of public transportation on the output growth of South Africa. Method: One-way error component panel analysis is adopted to analyse disaggregated data from eight major metros in the country from 2003 to 2017. Data were mainly sourced on public transport expenditure, total social infrastructure expenditure, total capital formation, labour expenditure and output growth rate from each of the metros. Results: The results were a clear departure from what was obtained by previous studies on transport expenditure and the growth of South Africa. Six of the metros which are the big ones in terms of the population showed a result, which indicated that public transport expenditure did not influence their output significantly; but when combined with other social infrastructure, it exhibited significant impact. However, the results of the remaining two small metros showed that public transport expenditure and its combination with other social infrastructure all had a significant impact on their output growth. Conclusion: This confirms transport infrastructure investment conforms to the theory of the diminishing marginal product of capital. The six big metros should invest more in social infrastructure, which would complement the contemporary transport infrastructure investment. On the other hand, there is still a need to increase public transport infrastructure investments on the smaller metros. [ABSTRACT FROM AUTHOR]

South Africa’s Transnet National Ports Authority’s (TNPA) tariff structure shows imbalances and cross-subsidisation amongst commodities and groups of port users. Benchmarking studies show that South African port costs are below the benchmarked mean for low-value bulk commodities like coal and iron ore, and above the mean for high-value containerised commodities. Vessel charges are also below the benchmarked mean and the required tariff revenues are raised from the tariffs charged to port tenants and cargo owners. This study examines and compares the 2013/2014 TNPA tariff structure with that proposed by the Ports Regulator of South Africa. It compiles, calculates and compares 254 commodity cargo dues with their relevant sector base tariffs for the year. The results indicate the level and direction of cross-subsidisation within and between break-bulk, dry bulk, liquid bulk and containerised cargoes. Of the 254 commodities examined, 100 are below the sector base tariff (being subsidised) and 154 are above (subsidising other cargoes). The findings of this article contribute to the implementation and monitoring of a tariff strategy that will allow for a more reasonable, just and cost reflective TNPA tariff structure. [ABSTRACT FROM AUTHOR]

Introduction: African adolescent girls and young women (AGYW) have high rates of HIV acquisition and are a priority population for HIV pre‐exposure prophylaxis (PrEP). PrEP implementation has been limited by AGYW's low perceived HIV risk and provider demands. A decision support tool (DST) with information about PrEP could improve clients' risk perception, knowledge about PrEP, informed decision‐making and motivation to use PrEP based on their risk, facilitating PrEP delivery in primary healthcare (PHC) clinics. Methods: We designed MyPrEP, a client‐facing DST about PrEP and HIV prevention, with youth‐friendly information and images. The impact of the MyPrEP tool was assessed among HIV‐negative women aged 18–25 years presenting to a PHC clinic in Johannesburg, South Africa from March 2019 to 2020. AGYW were randomized by day to the DST or a general health website as the control condition. A clinician blinded to DST versus control allocation provided standard of care counselling about PrEP, offered PrEP, administered a questionnaire and conducted sexually transmitted infection testing. The primary outcome was PrEP initiation and the secondary outcome was PrEP persistence at 1 month, determined by pharmacy dispensation records. Results: Of 386 AGYW screened, 353 were randomized (DST n = 172, control n = 181) with a median age of 21 years (interquartile range [IQR] 20, 23) and 56% (199/353) attending the clinic for HIV testing, 46% (164/353) using contraception, 15% (53/353) using condoms consistently and 37% (108/353) with a curable sexually transmitted infection. PrEP was initiated by 97% in the DST group and 94% in the control group (OR 1.79; 95% confidence interval, CI = 0.79–1.53), of whom two‐thirds planned to continue PrEP until they decided if they liked PrEP. At 1 month, PrEP persistence was 19% in the DST and 10% in the control group (OR 1.97, 95% CI 1.08–3.69). Ninety‐nine percent randomized to the DST reported satisfaction with MyPrEP. Conclusions: Among AGYW attending a South African PHC clinic, PrEP uptake was >90% with two‐fold higher PrEP persistence at 1 month in those randomized to use the MyPrEP DST. Given the need for strategies to support PrEP implementation and improve low PrEP persistence among African AGYW, a PrEP DST warrants further evaluation. [ABSTRACT FROM AUTHOR]

Women remain highly vulnerable to HIV infection in sub-Saharan Africa, with female sex workers (FSWs) facing some of the highest rates of HIV. Oral pre-exposure prophylaxis (PrEP) has the potential to reduce new infections among populations at highest risk and end-user perspectives of actual use in ‘real-world’ settings are critical to informing PrEP implementation. This paper presents findings from serial in-depth interviews (IDIs) conducted with FSW participants during the course of the Treatment And Prevention for Sex workers (TAPS) Demonstration Project in South Africa, exploring the lived experiences and perceptions of taking up and using PrEP. This research provides insight into risks and responsibilities facing FSWs perceived as prominent drivers in taking up and using PrEP, how PrEP was adopted to mitigate risk or ameliorate realities, and the characteristics of PrEP most valued, all of which are critical to consider in scale-up. Overall, distrust in the existence and/or efficacy of PrEP affected the motivation of women to come to the clinic and to maintain use. As one of the first reports of PrEP use among FSWs outside of a clinical trial setting, this research shows that it will be important to ensure accurate, relevant, and widespread messaging in communities to generate demand and support for PrEP. [ABSTRACT FROM AUTHOR]