PrEP reminds me that I am the one to take responsibility of my life: a qualitative study exploring experiences of and attitudes towards pre-exposure prophylaxis use by women in Eswatini.
PrEP reminds me that I am the one to take responsibility of my life: a qualitative study exploring experiences of and attitudes towards pre-exposure prophylaxis use by women in Eswatini.
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DOI：
10.1186/s12889-021-10766-0
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发表时间：
2021-04-14
影响因子：
4.5
通讯作者：
Wringe A
中科院分区：
文献类型：
--
作者：
Bjertrup PJ;Mmema N;Dlamini V;Ciglenecki I;Mpala Q;Matse S;Kerschberger B;Wringe A
暴露前预防（PrEP）因其使妇女控制预防艾滋病毒感染的潜力而受到欢迎，但在撒哈拉以南非洲的高发病率环境中，接受率和持续率一直令人失望。我们探讨了影响斯威士兰农村年轻妇女和孕妇或哺乳期妇女使用PrEP的结构和社会因素。我们进行了两次深入采访，10名妇女对PrEP，和一次深入采访，14名妇女拒绝或停止PrEP.Interviews涵盖了决策过程周围的PrEP启动和服用药丸的经验。深入访谈进行了9名卫生工作者，包括在提供PrEP服务的经验，和两个焦点小组的讨论与男子举行，以了解他们的看法PrEP.Interview和讨论进行录音，翻译，转录和分析的主题，使用归纳法。许多妇女都经历了PrEP的启动和使用，使她们能够控制自己的健康和福祉，并保持艾滋病毒，促进她们实现与母亲和教育成就有关的愿望。然而，界定与伙伴或家庭成员关系动态的社会规范，不是破坏就是促进这种赋权潜力。特别是，年轻女性很少得到家庭成员的支持，除非被认为是为了保护未出生的孩子。通过与艾滋病毒的关联和每日服药的负担，对服药的污名化也导致了PrEP的中止。与许多预防工具不同，PrEP使妇女能够实现对自己生活的控制感。然而，妇女机构继续和坚持PrEP受到社会和结构因素的影响，包括性别规范，年轻女性的家庭期望，关系动态和与艾滋病毒有关的耻辱。未来的干预措施应解决这些障碍，以促进性活跃妇女使用PrEP。
Pre-exposure-prophylaxis (PrEP) has been heralded for its potential to put women in control of preventing HIV infection, but uptake and continuation rates have been disappointing in high-incidence settings in sub-Saharan Africa. We explored structural and social factors that influenced PrEP use among young women and pregnant or breastfeeding women in rural Eswatini. We conducted two in-depth interviews with ten women on PrEP, and one-time in-depth interviews with fourteen women who declined or discontinued PrEP. Interviews covered decision-making processes around PrEP initiation and experiences with pill-taking. In-depth interviews were conducted with nine health workers, covering experiences in delivering PrEP services, and two focus group discussions were held with men to elicit their perceptions of PrEP. Interviews and discussions were audio-recorded, translated, transcribed and analysed thematically, using an inductive approach. PrEP initiation and use were experienced by many women as empowering them to take control of their health and well-being, and stay HIV free, facilitating them to realise their aspirations relating to motherhood and educational attainment. However, the social norms that defined relationship dynamics with partners or family members either undermined or promoted this empowerment potential. In particular, young women were rarely supported by family members to take PrEP unless it was perceived to be for protecting an unborn child. Stigmatisation of pill-taking through its associations with HIV and the burden of daily pill-taking also contributed to PrEP discontinuation. Unlike many prevention tools, PrEP enabled women to achieve a sense of control over their lives. Nevertheless, women’s agency to continue and adhere to PrEP was influenced by social and structural factors including gender norms, family expectations of young women, relationship dynamics and stigma related to HIV. Future interventions should address these barriers to promote PrEP use among sexually-active women.
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影响因子：
3.8
作者：
Fonner, Virginia A.;Dalglish, Sarah L.;Grant, Robert M.
通讯作者：
Grant, Robert M.
影响因子：
4.9
作者：
Ngure, Kenneth;Heffron, Renee;Baeten, Jared M.
通讯作者：
Baeten, Jared M.
DOI：
10.1097/qai.0000000000001960
发表时间：
2019-04-15
影响因子：
3.6
作者：
Montgomery, Elizabeth T.;Atujuna, Millicent;Minnis, Alexandra M.
通讯作者：
Minnis, Alexandra M.
DOI：
10.1016/s2352-3018(16)30190-4
发表时间：
2017-02
期刊：
The lancet. HIV
影响因子：
--
作者：
Justman J;Reed JB;Bicego G;Donnell D;Li K;Bock N;Koler A;Philip NM;Mlambo CK;Parekh BS;Duong YT;Ellenberger DL;El-Sadr WM;Nkambule R
通讯作者：
Nkambule R
影响因子：
9.3
作者：
Cork, Michael A.;Wilson, Kate F.;Dwyer-Lindgren, Laura
通讯作者：
Dwyer-Lindgren, Laura