Impact Research and Development Organization, Mito Jura Road, off Kisumu-Kakamega Highway, Kisumu, 9171 - 40141, Kenya.
Department of Population Health Sciences, Duke University, Durham, NC, USA.
BMC Womens Health. 2024 Apr 3;24(1):218. doi: 10.1186/s12905-024-03044-9.
Daily oral pre-exposure prophylaxis (PrEP) is an effective HIV prevention option for those who are most vulnerable to HIV infection, especially young women (YW). Objection by or lack of support from male sexual partners has been shown to impact YW's ability to take PrEP consistently. We explored the views of YW, and male partners and male peers of YW in Siaya County, Western Kenya, to illustrate how men influence, and can support, YW in using PrEP.
We used Photovoice to capture the views of YW ages 18-24 who were currently or previously enrolled in the DREAMS program and with current or previous experience taking PrEP. We also captured the views of YW's sexual partners and male peers. The YW completed eight photo assignments that focused on identifying factors influencing their PrEP use, and male participants completed four photo assignments focused on identifying ways men support or hinder YW's PrEP use. Photographs were presented and discussed in same- and mixed-gender groups using the SHOWeD method. YW also participated in in-depth interviews. The analysis focused on identifying themes that described men's influence on YW's PrEP adherence and persistence.
Among YW, a restricting male influence on PrEP use emerged in the majority of photo assignments such that YW's photographs and discussions revealed that men were more often viewed as barriers than supporters. YW perceived that they had little autonomy over their sexual lives and choice to use PrEP. YW's PrEP use was perceived to be hindered by stigmatizing community narratives that influenced men's support of PrEP use among women. Male participants suggested that men would support YW's PrEP use if PrEP was better promoted in the community and if men were more knowledgeable about its benefits.
A lack of support from male partners and peers and stigmatizing community narratives influence YW's PrEP use. Community-based programs should include education about PrEP specifically for male partners and peers of YW to positively influence PrEP use among YW.
每日口服暴露前预防（PrEP）是对那些最易感染 HIV 的人群，特别是年轻女性（YW）的有效 HIV 预防选择。研究表明，性伴侣的反对或不支持会影响 YW 持续服用 PrEP 的能力。本研究在肯尼亚西部 Siaya 县，探索了 YW、YW 的性伴侣和男性同伴的观点，以说明男性如何影响和支持 YW 使用 PrEP。
我们使用摄影作品来捕捉目前或之前参加 DREAMS 项目并正在或曾经使用 PrEP 的 18-24 岁 YW 的观点，还收集了 YW 性伴侣和男性同伴的观点。YW 完成了八项摄影任务，重点是确定影响他们使用 PrEP 的因素，而男性参与者则完成了四项摄影任务，重点是确定男性支持或阻碍 YW 使用 PrEP 的方式。使用 SHOWeD 方法在同性和混合性别小组中展示和讨论照片。YW 还参加了深入访谈。分析重点是确定描述男性对 YW 坚持和持续使用 PrEP 的影响的主题。
在 YW 中，大多数摄影任务都反映出限制 PrEP 使用的男性影响，即 YW 的照片和讨论表明，男性更多地被视为障碍而非支持者。YW 认为她们对自己的性生活和选择使用 PrEP 的自主权有限。社区中带有污名化的叙述影响了男性对女性使用 PrEP 的支持，从而阻碍了 YW 使用 PrEP。男性参与者建议，如果社区更好地宣传 PrEP，并且男性对其益处有更多的了解，那么男性会支持 YW 使用 PrEP。
缺乏性伴侣和同伴的支持以及带有污名化的社区叙述会影响 YW 使用 PrEP。基于社区的项目应包括专门针对 YW 的性伴侣和同伴的 PrEP 教育，以积极影响 YW 使用 PrEP。
