Reducing HIV is key 2030 SDG target. In Africa, HIV prevention research has focused on young women yet heterosexual men, vulnerable due to their mobility, remain WHO priority. Long-acting injectable cabotegravir (CAB-LA) and on-demand, oral pre-exposure prophylaxis (PrEP) have not been evaluated in such men who are not in-line to receive either. Building on our EU studies men want on-demand PrEP and CAB-LA (referred to as new PrEP options). This project using RE-AIM framework (Reach, Effectiveness, Adoption, Implementation and Maintenance), uses rapid assessment followed by implementation trial. Objectives 1: Catalysts/barriers across local and regional contexts that could influence uptake of new PrEP options by mobile men a. Qualitative assessment mobility patterns of men, knowledge/ perceptions of PrEP effectiveness b. Policy analysis at local and national level 2: Assess implementation effectiveness of new PrEP options by comparison of retention in care, effective use and expressed choice Open-label study of 400 men from mobile groups in South Africa and Uganda randomised to oral TDF-FTC or CAB-LA over 9 months, then access to both to 18months 3: Preferences of mobile men amongst new PrEP options a. Adoption of new PrEP options b. Barriers in non PrEP acceptors c. Patterns of PrEP use d. Participant/ staff / community reflections 4: Reach and implementation of PrEP for mobile men amongst service providers to inform scale-up a. Reach of PrEP b. Feasibility of delivering PrEP in different settings c. Fidelity of PrEP delivery in practice d. Service-level needs and adaptations to implement PrEP Objectives 3 and 4 use mixed methods in users and service providers. Objective 5: Affordability, cost and cost effectiveness of new PrEP options using HIV synthesis model This first multi-country study of on-demand PrEP and CAB-LA in men in Africa provides evidence for guidelines change, inform scalability, and provide operational tools for PrEP implementation.