Social and Behavioral Health Sciences, FHI 360, Durham, NC, USA;
Health Services Research, FHI 360, Durham, NC, USA.
J Int AIDS Soc. 2014 Sep 8;17(3 Suppl 2):19157. doi: 10.7448/IAS.17.3.19157. eCollection 2014.
Stakeholders continue to discuss the appropriateness of antiretroviral-based pre-exposure prophylaxis (PrEP) for HIV prevention among sub-Saharan African and other women. In particular, women need formulations they can adhere to given that effectiveness has been found to correlate with adherence. Evidence from family planning shows that contraceptive use, continuation and adherence may be increased by expanding choices. To explore the potential role of choice in women's use of HIV prevention methods, we conducted a secondary analysis of research with female sex workers (FSWs) and men and women in serodiscordant couples (SDCs) in Kenya, and adolescent and young women in South Africa. Our objective here is to present their interest in and preferences for PrEP formulations - pills, gel and injectable.
In this qualitative study, in Kenya we conducted three focus groups with FSWs, and three with SDCs. In South Africa, we conducted two focus groups with adolescent girls, and two with young women. All focus groups were audio-recorded, transcribed and translated into English as needed. We structurally and thematically coded transcripts using a codebook and QSR NVivo 9.0; generated code reports; and conducted inductive thematic analysis to identify major trends and themes.
All groups expressed strong interest in PrEP products. In Kenya, FSWs said the products might help them earn more money, because they would feel safer accepting more clients or having sex without condoms for a higher price. SDCs said the products might replace condoms and reanimate couples' sex lives. Most sex workers and SDCs preferred an injectable because it would last longer, required little intervention and was private. In South Africa, adolescent girls believed it would be possible to obtain the products more privately than condoms. Young women were excited about PrEP but concerned about interactions with alcohol and drug use, which often precede sex. Adolescents did not prefer a particular formulation but noted benefits and limitations of each; young women's preferences also varied.
The circumstances and preferences of sub-Saharan African women are likely to vary within and across groups and to change over time, highlighting the importance of choice in HIV prevention methods.
利益相关者继续讨论在撒哈拉以南非洲和其他地区的女性中使用基于抗逆转录病毒的暴露前预防（PrEP）进行 HIV 预防的适当性。特别是，鉴于有效性与依从性相关，女性需要她们能够坚持的制剂。计划生育方面的证据表明，扩大选择范围可能会增加避孕措施的使用、持续使用和依从性。为了探索选择在女性使用 HIV 预防方法中的潜在作用，我们对肯尼亚的女性性工作者（FSW）以及血清不一致夫妇（SDC）中的男性和女性和南非的青少年和年轻女性进行了一项二次分析。我们的目标是介绍她们对 PrEP 制剂（药丸、凝胶和注射剂）的兴趣和偏好。
在这项定性研究中，我们在肯尼亚进行了三项 FSW 焦点小组和三项 SDC 焦点小组的研究。在南非，我们进行了两项青春期少女焦点小组和两项年轻女性焦点小组的研究。所有焦点小组都进行了录音，需要时转录并翻译成英文。我们使用代码簿和 QSR NVivo 9.0 对转录本进行了结构性和主题性编码；生成代码报告；并进行了归纳主题分析，以确定主要趋势和主题。
所有群体都对 PrEP 产品表示出浓厚的兴趣。在肯尼亚，FSW 表示这些产品可能会帮助她们赚更多的钱，因为她们会感到更安全，可以接受更多的客户或不使用安全套进行更高价格的性行为。SDC 表示，这些产品可能会取代避孕套并重新激发夫妻的性生活。大多数性工作者和 SDC 更喜欢注射剂，因为它的作用时间更长，需要的干预较少，而且比较私密。在南非，青少年女孩认为可以比避孕套更私密地获得这些产品。年轻女性对 PrEP 感到兴奋，但担心与酒精和药物的相互作用，这些通常发生在性行为之前。青少年不喜欢特定的制剂，但注意到每种制剂的优缺点；年轻女性的偏好也各不相同。
撒哈拉以南非洲女性的情况和偏好可能在群体内部和群体之间有所不同，并随时间而变化，这突显了在 HIV 预防方法中选择的重要性。
