Brown University School of Public Health, Department of Behavioral and Social Sciences, Providence, RI, USA.
Gender and Health Research Unit, South African Medical Research Council, Durban, South Africa.
Womens Health (Lond). 2022 Jan-Dec;18:17455057221087117. doi: 10.1177/17455057221087117.
To explore women's willingness to consider using pre-exposure prophylaxis for HIV prevention in the context of gendered relationship dynamics, in Durban, South Africa.
As formative research prior to development of a gender-informed intervention to introduce pre-exposure prophylaxis to young, urban, educated women, we conducted six focus-group discussions and eight in-depth interviews with 46 women ages 18-25 years, who were not current pre-exposure prophylaxis users. Women were recruited from clinic and community settings using a criterion-based snowball sampling technique. Qualitative data were coded and analyzed thematically, with a team-based consensus approach for final coding, analytical decisions, and data interpretation.
Women clearly understood the benefits of pre-exposure prophylaxis for themselves and their partners, focusing on promoting health and their right to protect themselves from HIV infection. At the same time, and in accordance with findings from other studies, women were realistic about the concerns that would arise among male partners, including disapproval, loss of trust, possible loss of the relationship, and in some instances, the potential for violence, if they were to propose pre-exposure prophylaxis use. To resolve this tension, some women advocated for covert use as the best option for themselves and others argued for disclosure, proposing various approaches to working with partners to adopt pre-exposure prophylaxis. The suggestion that both partners use pre-exposure prophylaxis was made repeatedly. Thus, women sought to avoid discussions of trust or lack of trust and a partner's possible infidelities, choosing instead to focus on preserving or even building a relationship through suggesting pre-exposure prophylaxis use.
Women offered diverse narratives on agency and constraint in relation to choosing pre-exposure prophylaxis as a future prevention strategy, as well as ways to engage with their male partners about pre-exposure prophylaxis. These findings speak to the need for interventions to bolster women's confidence, sense of empowerment, and their communication and decision-making skills for successful HIV prevention.
在南非德班，探讨在性别关系动态背景下，女性对于使用暴露前预防（PrEP）进行 HIV 预防的意愿。
作为开发一种针对年轻城市受教育女性的性别知情干预措施的形成性研究，我们对 46 名年龄在 18-25 岁之间、目前未使用 PrEP 的女性进行了 6 次焦点小组讨论和 8 次深入访谈。通过基于标准的滚雪球抽样技术，在诊所和社区环境中招募女性。使用团队为基础的共识方法进行最终编码、分析决策和数据解释，对定性数据进行编码和主题分析。
女性清楚地了解 PrEP 对自己和伴侣的益处，重点是促进健康和保护自己免受 HIV 感染的权利。同时，与其他研究的结果一致，女性对男性伴侣可能会出现的担忧持现实态度，包括反对、失去信任、可能失去关系，在某些情况下，如果她们提出使用 PrEP，还可能会面临暴力。为了解决这种紧张关系，一些女性提倡秘密使用作为对自己和他人的最佳选择，而另一些女性则主张公开披露，提出了各种方法来与伴侣合作采用 PrEP。双方都使用 PrEP 的建议被反复提出。因此，女性避免讨论信任或缺乏信任以及伴侣可能的不忠问题，而是选择通过建议使用 PrEP 来专注于维持甚至建立关系。
女性就选择 PrEP 作为未来预防策略的能动性和约束性提出了多样化的叙述，以及与男性伴侣就 PrEP 进行沟通的方法。这些发现表明，需要采取干预措施来增强女性的信心、赋权感以及她们在成功预防 HIV 方面的沟通和决策技能。
