Peer Review Report For: Improving pre-exposure prophylaxis service delivery to gay men and other men who have sex with men in South Africa: Generating novel insights with a nudgeathon [version 1; peer review: 1 approved with reservations]

“Indlela - Behavioural Insights for Health” a behavioural science unit focused on improving health services in South Africa developed a pragmatic behavioural design framework called N-U-D-G-E. We used the nudgeathon approach to combine our technical expertise with stakeholder knowledge to apply this framework and rapidly co-create behavioural solutions designed to improve PrEP uptake and persistence amongst gay men and other men who have sex with men (MSM) in South Africa. Over two days we took 26 stakeholders divided into five teams through the framework and identified 602 solutions which were prioritized into two ideas per team and then pitched to an expert panel. This approach uncovered several high-potential, novel light-touch solutions to some of the challenges hindering PrEP delivery to gay men and other MSM in South Africa. This format is an effective way to engage stakeholders, including policy makers, in the process of both identifying behavioural barriers to optimal health decision making as well as creating novel solutions that can be tested.