Motivations for Reducing Other HIV Risk-Reduction Practices if Taking Pre-Exposure Prophylaxis: Findings from a Qualitative Study Among Women in Kenya and South Africa
Identifieur interne : 000B73 ( Pmc/Checkpoint ); précédent : 000B72; suivant : 000B74Motivations for Reducing Other HIV Risk-Reduction Practices if Taking Pre-Exposure Prophylaxis: Findings from a Qualitative Study Among Women in Kenya and South Africa
Auteurs : Amy Corneli ; Emily Namey ; Khatija Ahmed ; Kawango Agot ; Joseph Skhosana ; Jacob Odhiambo ; Greg GuestSource :
- AIDS Patient Care and STDs [ 1087-2914 ] ; 2015.
Abstract
Findings from a survey conducted among women at high risk for HIV in Bondo, Kenya, and Pretoria, South Africa, demonstrated that a substantial proportion would be inclined to reduce their use of other HIV risk-reduction practices if they were taking pre-exposure prophylaxis (PrEP). To explore the motivations for their anticipated behavior change, we conducted qualitative interviews with 60 women whose survey responses suggested they would be more likely to reduce condom use or have sex with a new partner if they were taking PrEP compared to if they were not taking PrEP. Three interrelated themes were identified: (1) “PrEP protects”—PrEP was perceived as an effective HIV prevention method that replaced the need for condoms; (2) condoms were a source of conflict in relationships, and PrEP would provide an opportunity to resolve or avoid this conflict; and (3) having sex without a condom or having sex with a new partner was necessary for receiving material goods and financial assistance—PrEP would provide reassurance in these situations. Many believed that PrEP alone would be a sufficient HIV risk-reduction strategy. These findings suggest that participants' HIV risk-reduction intentions, if they were to use PrEP, were based predominately on their understanding of the high efficacy of PrEP and their experiences with the limitations of condoms. Enhanced counseling is needed to promote informed decision making and to ensure overall sexual health for women using PrEP for HIV prevention, particularly with respect to the prevention of pregnancy and other sexually transmitted infections when PrEP is used alone.
Url:
DOI: 10.1089/apc.2015.0038
PubMed: 26196411
PubMed Central: 4553377
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<front><div type="abstract" xml:lang="en"><title>Abstract</title>
<p>Findings from a survey conducted among women at high risk for HIV in Bondo, Kenya, and Pretoria, South Africa, demonstrated that a substantial proportion would be inclined to reduce their use of other HIV risk-reduction practices if they were taking pre-exposure prophylaxis (PrEP). To explore the motivations for their anticipated behavior change, we conducted qualitative interviews with 60 women whose survey responses suggested they would be more likely to reduce condom use or have sex with a new partner if they were taking PrEP compared to if they were not taking PrEP. Three interrelated themes were identified: (1) “PrEP protects”—PrEP was perceived as an effective HIV prevention method that replaced the need for condoms; (2) condoms were a source of conflict in relationships, and PrEP would provide an opportunity to resolve or avoid this conflict; and (3) having sex without a condom or having sex with a new partner was necessary for receiving material goods and financial assistance—PrEP would provide reassurance in these situations. Many believed that PrEP alone would be a sufficient HIV risk-reduction strategy. These findings suggest that participants' HIV risk-reduction intentions, if they were to use PrEP, were based predominately on their understanding of the high efficacy of PrEP and their experiences with the limitations of condoms. Enhanced counseling is needed to promote informed decision making and to ensure overall sexual health for women using PrEP for HIV prevention, particularly with respect to the prevention of pregnancy and other sexually transmitted infections when PrEP is used alone.</p>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">AIDS Patient Care STDS</journal-id>
<journal-id journal-id-type="iso-abbrev">AIDS Patient Care STDS</journal-id>
<journal-id journal-id-type="publisher-id">apc</journal-id>
<journal-title-group><journal-title>AIDS Patient Care and STDs</journal-title>
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<issn pub-type="ppub">1087-2914</issn>
<issn pub-type="epub">1557-7449</issn>
<publisher><publisher-name>Mary Ann Liebert, Inc.</publisher-name>
<publisher-loc>140 Huguenot Street, 3rd FloorNew Rochelle, NY 10801USA</publisher-loc>
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<article-id pub-id-type="pmc">4553377</article-id>
<article-id pub-id-type="publisher-id">10.1089/apc.2015.0038</article-id>
<article-id pub-id-type="doi">10.1089/apc.2015.0038</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Behavioral and Psychosocial Research</subject>
</subj-group>
</article-categories>
<title-group><article-title>Motivations for Reducing Other HIV Risk-Reduction Practices if Taking Pre-Exposure Prophylaxis: Findings from a Qualitative Study Among Women in Kenya and South Africa</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Corneli</surname>
<given-names>Amy</given-names>
</name>
<degrees>PhD, MPH</degrees>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Namey</surname>
<given-names>Emily</given-names>
</name>
<degrees>MA</degrees>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ahmed</surname>
<given-names>Khatija</given-names>
</name>
<degrees>MBChB, MMed, Micro</degrees>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Agot</surname>
<given-names>Kawango</given-names>
</name>
<degrees>PhD, MPH</degrees>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Skhosana</surname>
<given-names>Joseph</given-names>
</name>
<degrees>BTechBioSci</degrees>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
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<contrib contrib-type="author"><name><surname>Odhiambo</surname>
<given-names>Jacob</given-names>
</name>
<degrees>MA</degrees>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
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<contrib contrib-type="author"><name><surname>Guest</surname>
<given-names>Greg</given-names>
</name>
<degrees>PhD, MA</degrees>
<xref ref-type="aff" rid="aff1"><sup>1,</sup>
</xref>
<xref ref-type="author-notes" rid="fn1"><sup>*</sup>
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<aff id="aff1"><label><sup>1</sup>
</label>
<institution>Social and Behavioral Health Sciences</institution>
, FHI 360, Durham, North Carolina.</aff>
<aff id="aff2"><label><sup>2</sup>
</label>
<institution>Impact Research and Development Organization</institution>
, Kisumu,<country>Kenya</country>
.</aff>
<aff id="aff3"><label><sup>3</sup>
</label>
<institution>Setshaba Research Centre</institution>
, Pretoria,<country>South Africa</country>
.</aff>
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<author-notes><fn id="fn1" fn-type="current-aff"><label><sup>*</sup>
</label>
<p>Current affiliation: Economic Development and Livelihoods, FHI 360, Durham, North Carolina.</p>
</fn>
<fn id="fn2" fn-type="other"><p>These data were previously presented as an oral poster at the 20<sup>th</sup>
International AIDS Conference, Melbourne, Australia, July, 20–25, 2014 [MOPDD01].</p>
</fn>
<corresp><addr-line>Address correspondence to:</addr-line>
<addr-line><italic>Dr. Amy Corneli</italic>
</addr-line>
<addr-line><italic>FHI 360</italic>
</addr-line>
<institution><italic>Social and Behavioral Health Sciences</italic>
</institution>
<addr-line><italic>359 Blackwell St, Suite 200</italic>
</addr-line>
<addr-line><italic>Durham, NC 27701</italic>
</addr-line>
<italic>E-mail:</italic>
<email xlink:href="mailto:acorneli@fhi360.org">acorneli@fhi360.org</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><day>01</day>
<month>9</month>
<year>2015</year>
<pmc-comment>string-date: September 2015</pmc-comment>
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<volume>29</volume>
<issue>9</issue>
<fpage>503</fpage>
<lpage>509</lpage>
<permissions><copyright-statement>Copyright 2015, Mary Ann Liebert, Inc.</copyright-statement>
<copyright-year>2015</copyright-year>
</permissions>
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<abstract><title>Abstract</title>
<p>Findings from a survey conducted among women at high risk for HIV in Bondo, Kenya, and Pretoria, South Africa, demonstrated that a substantial proportion would be inclined to reduce their use of other HIV risk-reduction practices if they were taking pre-exposure prophylaxis (PrEP). To explore the motivations for their anticipated behavior change, we conducted qualitative interviews with 60 women whose survey responses suggested they would be more likely to reduce condom use or have sex with a new partner if they were taking PrEP compared to if they were not taking PrEP. Three interrelated themes were identified: (1) “PrEP protects”—PrEP was perceived as an effective HIV prevention method that replaced the need for condoms; (2) condoms were a source of conflict in relationships, and PrEP would provide an opportunity to resolve or avoid this conflict; and (3) having sex without a condom or having sex with a new partner was necessary for receiving material goods and financial assistance—PrEP would provide reassurance in these situations. Many believed that PrEP alone would be a sufficient HIV risk-reduction strategy. These findings suggest that participants' HIV risk-reduction intentions, if they were to use PrEP, were based predominately on their understanding of the high efficacy of PrEP and their experiences with the limitations of condoms. Enhanced counseling is needed to promote informed decision making and to ensure overall sexual health for women using PrEP for HIV prevention, particularly with respect to the prevention of pregnancy and other sexually transmitted infections when PrEP is used alone.</p>
</abstract>
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<tree><noCountry><name sortKey="Agot, Kawango" sort="Agot, Kawango" uniqKey="Agot K" first="Kawango" last="Agot">Kawango Agot</name>
<name sortKey="Ahmed, Khatija" sort="Ahmed, Khatija" uniqKey="Ahmed K" first="Khatija" last="Ahmed">Khatija Ahmed</name>
<name sortKey="Corneli, Amy" sort="Corneli, Amy" uniqKey="Corneli A" first="Amy" last="Corneli">Amy Corneli</name>
<name sortKey="Guest, Greg" sort="Guest, Greg" uniqKey="Guest G" first="Greg" last="Guest">Greg Guest</name>
<name sortKey="Namey, Emily" sort="Namey, Emily" uniqKey="Namey E" first="Emily" last="Namey">Emily Namey</name>
<name sortKey="Odhiambo, Jacob" sort="Odhiambo, Jacob" uniqKey="Odhiambo J" first="Jacob" last="Odhiambo">Jacob Odhiambo</name>
<name sortKey="Skhosana, Joseph" sort="Skhosana, Joseph" uniqKey="Skhosana J" first="Joseph" last="Skhosana">Joseph Skhosana</name>
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