Pre-exposure prophylaxis use among HIV serodiscordant couples: a qualitative study in Mozambique. 2021

Daniel E Sack, and Caroline De Schacht, and Paula Paulo, and Erin Graves, and Almiro M Emílio, and Ariano Matino, and Carlota L Fonseca, and Arifo U Aboobacar, and Sara Van Rompaey, and Carolyn M Audet
Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA.

Pre-exposure prophylaxis (PrEP) has the potential to reduce HIV transmission and stem the HIV epidemic. Unfortunately, PrEP uptake in rural sub-Saharan Africa has been slow and medication adherence has been suboptimal. To explore the perspectives, attitudes, and experiences of HIV serodiscordant partners taking PrEP and develop a messaging campaign to improve PrEP uptake in rural Mozambique to reduce HIV transmission among serodiscordant partners. In this qualitative study, we interviewed 20 people in serodiscordant relationships using PrEP at a rural health center in Zambézia province, Mozambique and employed inductive and deductive coding to elicit their perspectives, attitudes, and experiences related to learning their partner's HIV status, barriers to PrEP uptake, obstacles to PrEP adherence, and decisions to disclose their PrEP use with family and friends using thematic analysis. Our analysis generated nine themes across various levels of the socioecological model. Participants reported a strong desire to stay in the discordant relationship and highlighted the importance of working together to ensure PrEP and antiretroviral therapy adherence, with the majority skeptical that adherence could be achieved without both partners' support (individual and interpersonal). Although most participants were reticent about sharing their serodiscordant status with family and friends (individual and interpersonal), those who did found their family and friends supportive (interpersonal). Participants suggested increasing community health agent availability to help people navigate HIV prevention and treatment (organizational). We then created three oral stories, using themes from the interviews, with examples from various levels of the socioecological model that will be used to generate support for PrEP use among community members. Our findings informed oral template stories that will be used to emphasize how couples can work together to improve PrEP uptake and reduce incident HIV infections in serodiscordant couples elsewhere in rural Mozambique.

UI MeSH Term Description Entries
D009073 Mozambique A republic in southern Africa, south of TANZANIA, east of ZAMBIA and ZIMBABWE, bordered on the west by the Indian Ocean. Its capital is Maputo. It was formerly called Portuguese East Africa. Portuguese East Africa,Republic of Mozambique
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012747 Sexual Partners Married or single individuals who share sexual relations. Multiple Partners Sexual,Multiple Sex Partners,Multiple Sexual Partners,Sex Partners,Partner, Sex,Partner, Sexual,Sex Partner,Sex Partner, Multiple,Sex Partners, Multiple,Sexual Partner,Sexual Partner, Multiple
D015658 HIV Infections Includes the spectrum of human immunodeficiency virus infections that range from asymptomatic seropositivity, thru AIDS-related complex (ARC), to acquired immunodeficiency syndrome (AIDS). HTLV-III Infections,HTLV-III-LAV Infections,T-Lymphotropic Virus Type III Infections, Human,HIV Coinfection,Coinfection, HIV,Coinfections, HIV,HIV Coinfections,HIV Infection,HTLV III Infections,HTLV III LAV Infections,HTLV-III Infection,HTLV-III-LAV Infection,Infection, HIV,Infection, HTLV-III,Infection, HTLV-III-LAV,Infections, HIV,Infections, HTLV-III,Infections, HTLV-III-LAV,T Lymphotropic Virus Type III Infections, Human
D019380 Anti-HIV Agents Agents used to treat AIDS and/or stop the spread of the HIV infection. These do not include drugs used to treat symptoms or opportunistic infections associated with AIDS. AIDS Drug,AIDS Drugs,Anti-AIDS Agents,Anti-AIDS Drug,Anti-HIV Agent,Anti-HIV Drug,Anti-AIDS Drugs,Anti-HIV Drugs,Agent, Anti-HIV,Agents, Anti-AIDS,Agents, Anti-HIV,Anti AIDS Agents,Anti AIDS Drug,Anti AIDS Drugs,Anti HIV Agent,Anti HIV Agents,Anti HIV Drug,Anti HIV Drugs,Drug, AIDS,Drug, Anti-AIDS,Drug, Anti-HIV,Drugs, AIDS,Drugs, Anti-AIDS,Drugs, Anti-HIV
D065129 Pre-Exposure Prophylaxis A method of disease prevention (abbreviated PrEP) which involves the administration of drugs to at-risk persons who have not been exposed to the disease-causing agent. Pre-Exposure Prophylaxis (PrEP),Pre Exposure Prophylaxis,Pre Exposure Prophylaxis (PrEP),Pre-Exposure Prophylaxi,Pre-Exposure Prophylaxi (PrEP),Prophylaxi, Pre-Exposure,Prophylaxi, Pre-Exposure (PrEP),Prophylaxis, Pre-Exposure,Prophylaxis, Pre-Exposure (PrEP)

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