Wong Christina Misa, Munthali Tendai, Mangunje Featherstone G, Katoka Mercy L, Burke Holly M, Musonda Bupe, Musonda Musonda, Todd Catherine S
Global Health & Population, FHI 360, 359 Blackwell Street, Suite 200, Durham, NC, 27701, USA.
Ministry of Health, Government of the Republic of Zambia, Ndeke House, Haile Selassie Avenue, P.O. Box 30205, Lusaka, Zambia.
BMC Womens Health. 2024 Jan 25;24(1):71. doi: 10.1186/s12905-024-02913-7.
Zambian adolescent girls and young women (AGYW) have high HIV incidence and face barriers to the use of pre-exposure prophylaxis (PrEP). Parental support improves PrEP use and adherence in some settings, but negative parental attitudes toward HIV prevention may inhibit engagement with AGYW. We explored perceptions of future PrEP methods among AGYW and parents and parent-youth engagement on HIV prevention and PrEP use.
We conducted a qualitative descriptive study among AGYW and parents of AGYW in five provinces in Zambia in September-October 2021. We conducted 10 focus group discussions (FGDs) and four in-depth interviews (IDIs) with AGYW participants (n = 87) and seven FGDs and four IDIs among parents of AGYW (n = 62). All FGDs and IDIs were audio-recorded, transcribed verbatim, and analyzed to identify qualitative themes.
Most AGYW participants preferred the discreet nature and longer duration of injectable PrEP compared to the PrEP ring and oral PrEP. Many AGYWs reported inability to disclose PrEP use to their parents due to lack of parental support based on cultural taboos against premarital sex. Nevertheless, AGYW participants said they would like to talk to their parents about PrEP so their parents could support their use. Many parents also described difficulties discussing PrEP with their daughters because of cultural and religious beliefs about abstinence from sex before marriage. However, parents acknowledged that the threat of HIV is real and said they need PrEP knowledge and guidance on speaking with their children about HIV prevention and PrEP.
Although many parents are currently not playing a role in daughters' decisions about PrEP use, both parents and AGYW are willing to engage with each other on HIV prevention issues. To foster parent-child engagement, HIV prevention programs should not only provide information about PrEP but also address social norms that impede discussion of HIV prevention and equip both parents and AGYW with skills and support for such conversations. Community sensitization is also needed as new PrEP products are introduced, to create an enabling environment for parent-child engagement by increasing awareness, countering misconceptions, and reducing stigma.
赞比亚的青春期少女和年轻女性（AGYW）艾滋病毒感染率很高，并且在使用暴露前预防（PrEP）方面面临障碍。在某些情况下，父母的支持可提高PrEP的使用和依从性，但父母对艾滋病毒预防的负面态度可能会阻碍与AGYW的接触。我们探讨了AGYW和父母对未来PrEP方法的看法，以及父母与青少年在艾滋病毒预防和PrEP使用方面的接触情况。
2021年9月至10月，我们在赞比亚五个省份的AGYW及其父母中开展了一项定性描述性研究。我们与AGYW参与者（n = 87）进行了10次焦点小组讨论（FGD）和4次深入访谈（IDI），并与AGYW的父母（n = 62）进行了7次FGD和4次IDI。所有FGD和IDI均进行了录音，逐字转录，并进行分析以确定定性主题。
与PrEP环和口服PrEP相比，大多数AGYW参与者更喜欢注射用PrEP的隐秘性和更长的持续时间。许多AGYW报告称，由于基于反对婚前性行为的文化禁忌而缺乏父母支持，无法向父母透露PrEP的使用情况。然而，AGYW参与者表示，他们希望与父母谈论PrEP，以便父母能够支持他们使用。许多父母也表示，由于关于婚前禁欲的文化和宗教信仰，很难与女儿讨论PrEP。然而，父母承认艾滋病毒的威胁是真实存在的，并表示他们需要PrEP知识以及关于如何与孩子谈论艾滋病毒预防和PrEP的指导。
尽管目前许多父母在女儿关于PrEP使用的决定中没有发挥作用，但父母和AGYW都愿意就艾滋病毒预防问题进行沟通。为了促进亲子沟通，艾滋病毒预防项目不仅应提供有关PrEP的信息，还应解决阻碍艾滋病毒预防讨论的社会规范，并为父母和AGYW提供进行此类对话的技能和支持。随着新的PrEP产品推出，还需要进行社区宣传，通过提高认识、消除误解和减少耻辱感，为亲子沟通创造有利环境。
