Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan 1;14(1):1940764.
doi: 10.1080/16549716.2021.1940764.

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

Daniel E Sack  1 , Caroline De Schacht  2 , Paula Paulo  3 , Erin Graves  1 , Almiro M Emílio  3 , Ariano Matino  3 , Carlota L Fonseca  3 , Arifo U Aboobacar  3 , Sara Van Rompaey  2 , Carolyn M Audet  1
Affiliations

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

Daniel E Sack et al. Glob Health Action. .

Abstract

Background: 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.

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Trial registration: ClinicalTrials.gov NCT04071470.

Keywords: HIV/AIDS; Mozambique; PrEP; discordant couples; rural Africa.

PubMed Disclaimer

Conflict of interest statement

The authors declare they have no competing interests.

Figures

Figure 1.
Figure 1.
Socioecological factors influencing pre-exposure prophylaxis use among couples in HIV discordant relationships in rural Mozambique
See this image and copyright information in PMC

References

    1. Cori A, Ayles H, Beyers N, et al. HPTN 071 PopART Study Team. HPTN 071 (PopART): a cluster-randomized trial of the population impact of an HIV combination prevention intervention including universal testing and treatment: mathematical model. PloS One. 2014;9:e84511. - PMC - PubMed
    1. Eaton JW, Johnson LF, Salomon JA, et al. HIV treatment as prevention: systematic comparison of mathematical models of the potential impact of antiretroviral therapy on HIV incidence in South Africa. PLoS Med. 2012;9:e1001245. - PMC - PubMed
    1. World Health Organization . WHO | guidance on oral pre-exposure prophylaxis (PrEP) for serodiscordant couples, men and transgender women who have sex with men at high risk of HIV [Internet]. Geneva, Switzerland: World Health Organization; 2012. Jul [cited 2020 Apr 27]. Available from: https://www.who.int/hiv/pub/guidance_prep/en/ - PubMed
    1. UNAIDS . HIV prevention 2020 road map — accelerating HIV prevention to reduce new infections by 75% [Internet]. Geneva, Switzerland; 2016; p. 36. Available from: https://www.unaids.org/sites/default/files/media_asset/hiv-prevention-20...
    1. Burns DN, Grossman C, Turpin J, et al. Role of oral pre-exposure prophylaxis (PrEP) in current and future HIV prevention strategies. Curr HIV/AIDS Rep. 2014. Dec 1;11:393–10. - PubMed

Publication types

Substances

Associated data