TY - JOUR
T1 - HIV-Uninfected Kenyan Adolescent and Young Women Share Perspectives on Using Pre-Exposure Prophylaxis during Pregnancy
AU - Pintye, Jillian
AU - Beima-Sofie, Kristin M.
AU - Makabong'o, Pamela A.
AU - Njoroge, Anne
AU - Trinidad, Susan Brown
AU - Heffron, Renee A.
AU - Baeten, Jared M.
AU - Celum, Connie
AU - Matemo, Daniel
AU - Kinuthia, John
AU - Kelley, Maureen C.
AU - John-Stewart, Grace C.
N1 - Funding Information:
This study was funded through the National Institutes of Health grant (T32AI07140 and F32NR017125 to J.P., K24 HD054314 to G.J.S.) and received assistance from the University of Washington Center for AIDS Research (P30 AI27757) and the University of Washington’s Global Center for Integrated Health of Women Adolescents and Children (Global WACh).The Partners Demonstration Project was funded by the US National Institutes of Mental Health (R01 MH095507), the Bill and Melinda Gates Foundation (grants no. OPP47674, OPP1056051), and the US Agency for International Development (contract AID-OAA-A-12-00023). M.K.’s effort was supported by a Wellcome Trust Strategic Award (096527) and Wellcome-MRC Newton Fund collaborative award (200344).
Publisher Copyright:
© 2018, Mary Ann Liebert, Inc., publishers.
PY - 2018/12
Y1 - 2018/12
N2 - To optimize scale-up of pre-exposure prophylaxis (PrEP) for pregnant women at risk of HIV in high HIV burden settings, implementation strategies must be developed that account for perceptions of PrEP in this unique population. Semistructured focus group discussions were conducted with 68 HIV-uninfected Kenyan pregnant and postpartum women without prior PrEP knowledge or experience. A qualitative descriptive analysis was performed, using a constant comparison approach, to identify key themes related to the values and rationale impacting potential PrEP use in pregnancy. Median age was 19.5 years and participants were either pregnant or had 1-2 children. Almost all (96%) were married or had a steady partner. Women felt pregnancy was a time of high HIV risk because they desired sex less frequently, which may lead their partners to have outside partnerships. This made PrEP an attractive HIV prevention option for themselves and their infants. Although women believed male partner behaviors influenced their HIV risk, many women perceived that male partners would react negatively, including becoming physically violent, if they discovered that women used PrEP. Clinicians were identified as potential facilitators of PrEP use who could explain PrEP to male partners on behalf of pregnant women. Women said that community-level stigma against HIV and potential for conflating PrEP with antiretroviral therapy (ART) would necessitate that PrEP use be discreet. Our results indicate the importance of addressing risk perception of women, concerns of male partners, HIV stigma, and benefits of PrEP for HIV prevention as programs are developed for pregnant women.
AB - To optimize scale-up of pre-exposure prophylaxis (PrEP) for pregnant women at risk of HIV in high HIV burden settings, implementation strategies must be developed that account for perceptions of PrEP in this unique population. Semistructured focus group discussions were conducted with 68 HIV-uninfected Kenyan pregnant and postpartum women without prior PrEP knowledge or experience. A qualitative descriptive analysis was performed, using a constant comparison approach, to identify key themes related to the values and rationale impacting potential PrEP use in pregnancy. Median age was 19.5 years and participants were either pregnant or had 1-2 children. Almost all (96%) were married or had a steady partner. Women felt pregnancy was a time of high HIV risk because they desired sex less frequently, which may lead their partners to have outside partnerships. This made PrEP an attractive HIV prevention option for themselves and their infants. Although women believed male partner behaviors influenced their HIV risk, many women perceived that male partners would react negatively, including becoming physically violent, if they discovered that women used PrEP. Clinicians were identified as potential facilitators of PrEP use who could explain PrEP to male partners on behalf of pregnant women. Women said that community-level stigma against HIV and potential for conflating PrEP with antiretroviral therapy (ART) would necessitate that PrEP use be discreet. Our results indicate the importance of addressing risk perception of women, concerns of male partners, HIV stigma, and benefits of PrEP for HIV prevention as programs are developed for pregnant women.
KW - Africa
KW - PrEP
KW - obstetrics/gynecology
KW - prevention of mother to child transmission/vertical transmission
KW - prevention of sexual transmission
KW - qualitative data
KW - women
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UR - http://www.scopus.com/inward/citedby.url?scp=85058023980&partnerID=8YFLogxK
U2 - 10.1089/apc.2018.0058
DO - 10.1089/apc.2018.0058
M3 - Article
C2 - 30036072
AN - SCOPUS:85058023980
SN - 1087-2914
VL - 32
SP - 538
EP - 544
JO - AIDS Patient Care and STDs
JF - AIDS Patient Care and STDs
IS - 12
ER -