“People have options”: a qualitative study of experiences and influences of PrEP choice among women in South Africa

IF 4.9 1区 医学 Q2 IMMUNOLOGY
Siphokazi Dada, Faith Mary Musvipwa, Fatima Abegail Cholo, Melanie Pleaner, Alison Kutywayo, Vusile Butler, Catherine Elizabeth Martin, Saiqa Mullick
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引用次数: 0

Abstract

Introduction

Long-acting injectable cabotegravir and dapivirine vaginal ring were recently introduced in South Africa through demonstration projects, providing additional HIV prevention options to oral pre-exposure prophylaxis (PrEP). PrEP choice marks a pivotal moment in HIV prevention, potentially increasing PrEP uptake and use by offering women a choice of methods best suited to their individual needs. Understanding experiences of PrEP choice in real-world settings is critical to informing the introduction of PrEP choice at scale. This study, embedded within an implementation science study introducing new PrEP methods, explores women's experiences of PrEP choice counselling, and factors influencing PrEP choice.

Methods

Between April and May 2024, we conducted 12 focus group discussions with a sub-set of 126 women (18–57 years) enrolled in a parent cohort study delivering PrEP choice at six fixed and three roving mobile clinics in three areas of South Africa. Cohort participants are HIV-negative men and women ≥ 15 years interested in HIV prevention services. At the time of data collection, non-pregnant and lactating women ≥ 18 years enrolled in the cohort were provided PrEP choice counselling and offered a choice of oral PrEP or dapivirine vaginal ring. Discussions explored women's experiences of PrEP choice counselling and influences of PrEP choice. They were audio recorded, transcribed verbatim and translated into English for thematic analysis.

Results

Women reported positive choice counselling experiences, particularly when it was supplemented by pamphlets, demonstration rings and pelvic models. Participants valued learning about alternative PrEP methods and appreciated friendly healthcare providers who answered their questions. Privacy and emotional support were also crucial. However, negative experiences included the use of complex scientific jargon and insufficient information on PrEP's potential drawbacks. PrEP choices were mainly influenced by concerns about intravaginal products, distrust of new methods, prior oral PrEP experiences, and partner and family opinions.

Conclusions

These findings will guide strategies for PrEP delivery, emphasizing provider training, effective counselling tools and tailored communication. Women valued clear, jargon-free information, visual aids and a welcoming environment, which supported open dialogue. The influence of prior oral PrEP experiences on PrEP choice highlights the need for counselling that addresses specific concerns and preferences.

Abstract Image

“人们有选择”:对南非妇女选择预防PrEP的经验和影响的定性研究
南非最近通过示范项目引进长效注射卡博特韦和达匹维林阴道环,为口服暴露前预防提供了额外的艾滋病毒预防选择。预防措施的选择标志着艾滋病毒预防的关键时刻,通过为妇女提供最适合其个人需求的方法选择,有可能增加预防措施的接受和使用。了解在现实环境中选择预防措施的经验对于大规模采用预防措施至关重要。本研究是一项实施科学研究的一部分,该研究介绍了新的PrEP方法,探讨了妇女在PrEP选择咨询方面的经验,以及影响PrEP选择的因素。方法在2024年4月至5月期间,我们对126名妇女(18-57岁)进行了12次焦点小组讨论,这些妇女参加了一项父母队列研究,在南非三个地区的六个固定诊所和三个流动流动诊所提供PrEP选择。队列参与者为艾滋病毒阴性的男性和女性,年龄≥15岁,对艾滋病毒预防服务感兴趣。收集数据时,≥18岁的非怀孕和哺乳期妇女接受PrEP选择咨询,并可选择口服PrEP或达匹维林阴道环。讨论了妇女PrEP选择咨询的经验和PrEP选择的影响。它们被录音,逐字抄录并翻译成英语以供专题分析。结果妇女报告积极的选择咨询经验,特别是当它补充了小册子,示范环和盆腔模型。参与者重视学习替代性PrEP方法,并感谢友好的医疗保健提供者回答他们的问题。隐私和情感支持也很重要。然而,负面的经历包括使用复杂的科学术语和对PrEP潜在缺点的信息不足。对阴道内产品的担忧、对新方法的不信任、既往口服PrEP经验以及伴侣和家人意见是影响PrEP选择的主要因素。结论这些发现将指导PrEP的实施策略,强调提供者培训、有效的咨询工具和量身定制的沟通。妇女们重视清晰、无行话的信息、视觉辅助和支持公开对话的友好环境。先前口服预防措施经验对预防措施选择的影响突出表明,需要针对具体问题和偏好进行咨询。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of the International AIDS Society
Journal of the International AIDS Society IMMUNOLOGY-INFECTIOUS DISEASES
CiteScore
8.60
自引率
10.00%
发文量
186
审稿时长
>12 weeks
期刊介绍: The Journal of the International AIDS Society (JIAS) is a peer-reviewed and Open Access journal for the generation and dissemination of evidence from a wide range of disciplines: basic and biomedical sciences; behavioural sciences; epidemiology; clinical sciences; health economics and health policy; operations research and implementation sciences; and social sciences and humanities. Submission of HIV research carried out in low- and middle-income countries is strongly encouraged.
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