Hamoonga Twaambo Euphemia, Mutale Wilbroad, Hampanda Karen, Chi Benjamin H
Department of Population Studies and Global Health, School of Public Health, University of Zambia, Lusaka, Zambia.
Department of Health Systems Management and Policy, School of Public Health, University of Zambia, Lusaka, Zambia.
Front Reprod Health. 2025 Aug 22;7:1540248. doi: 10.3389/frph.2025.1540248. eCollection 2025.
HIV risk perception is seen as a key motivation for individuals to use biomedical HIV prevention interventions, including pre-exposure prophylaxis (PrEP). We determined HIV risk perception and associated factors among pregnant and breastfeeding women in Lusaka, Zambia.
We conducted a cross sectional study among pregnant and breastfeeding women not living with HIV in a hospital setting in Lusaka, Zambia. Study team members administered a structured questionnaire to pregnant and breastfeeding women at the hospital's maternal and child health clinic to get information on socio-demographics, obstetrics and pregnancy history, sexual behavior and HIV risk perception. Participants assessed their HIV risk perception (outcome variable) as no, low, moderate, or high; these were later collapsed into a binary variable of lower vs. higher risk. Logistic regression analysis was used to determine factors associated with high HIV self-risk perception.
From September to December 2021, we recruited 389 pregnant and breastfeeding women in our study. Of these, 172 (44%) were pregnant and 217 (56%) were breastfeeding. Most participants were aged between 25 and 34 years 181 (47%), and the majority 338 (87%) never used a condom with their regular sexual partner. About 129 (33%) of participants perceived higher HIV risk. This appeared higher in breastfeeding vs. pregnant women (40% vs. 25%).Over half (52%) of participants with unknown partner HIV status and one-third (33%) of those who never used condoms with their regular sexual partners perceived higher HIV risk. In adjusted models, higher HIV self-risk perception was associated with breastfeeding status (AOR = 1.82; 95% CI: 1.14-2.91), having more than 5 lifetime sexual partners (AOR = 4.27; 95% CI: 1.84-9.90), and having a partner of unknown HIV status (AOR = 2.15; 95% CI: 1.22-3.78).
A low proportion of women perceived higher HIV risk, even when their sexual behaviours and partner characteristics would suggest HIV exposure. HIV prevention programs should focus on the accurate assessment of HIV risk to improve uptake of PrEP in the study population.
艾滋病病毒（HIV）风险认知被视为个人使用生物医学HIV预防干预措施（包括暴露前预防，即PrEP）的关键动机。我们确定了赞比亚卢萨卡孕妇和哺乳期妇女的HIV风险认知及相关因素。
我们在赞比亚卢萨卡一家医院对未感染HIV的孕妇和哺乳期妇女进行了一项横断面研究。研究团队成员在医院的妇幼保健诊所向孕妇和哺乳期妇女发放了一份结构化问卷，以获取有关社会人口统计学、产科和妊娠史、性行为及HIV风险认知的信息。参与者将其HIV风险认知（结果变量）评估为无、低、中或高；这些后来被合并为一个低风险与高风险的二元变量。采用逻辑回归分析来确定与高HIV自我风险认知相关的因素。
2021年9月至12月，我们在研究中招募了389名孕妇和哺乳期妇女。其中，172名（44%）为孕妇，217名（56%）为哺乳期妇女。大多数参与者年龄在25至34岁之间，有181名（47%），且大多数338名（87%）从未与固定性伴侣使用过避孕套。约129名（33%）参与者认为HIV风险较高。这在哺乳期妇女中比孕妇中更高（40%对25%）。超过一半（52%）伴侣HIV感染状况未知的参与者以及三分之一（33%）从未与固定性伴侣使用过避孕套的参与者认为HIV风险较高。在调整后的模型中，较高的HIV自我风险认知与哺乳状态（比值比[AOR]=1.82；95%置信区间[CI]：1.14 - 2.91）、一生中有超过5个性伴侣（AOR = 4.27；95% CI：1.84 - 9.90）以及伴侣HIV感染状况未知（AOR = 2.15；95% CI：1.22 - 3.78）相关。
即使女性的性行为和伴侣特征表明其有HIV暴露风险，但只有一小部分女性认为HIV风险较高。HIV预防项目应专注于对HIV风险的准确评估，以提高研究人群中PrEP的使用率。
