“Why should I use a condom when I have a wife”? Barriers and motivations to PrEP use among HIV-1 serodiscordant couples in the Nigeria PrEP demonstration project: a qualitative perspective
Year: 2019
Type: other
Abstract: Background: Antiretroviral pre-exposure prophylaxis (PrEP) reduces risk of HIV acquisition when taken regularly. Consistent condom use in addition to PrEP is critical for prevention of STI transmission. We qualitatively explored barriers and motivation to PrEP use among serodiscordant couples enrolled in the PrEP demonstration project in Nigeria. Methods: Thirty eight (n=38) interviews were conducted across the demonstration sites. Four focus groups were held with joint couples. Interview questions covered (a) perception of sero discordancy, (b) barriers and motivation for use of PrEP, (c) history of condom use, and (d) changes in sexual activities. Responses corresponding to each study question were inductively summarized and assigned to descriptive categories using a coding scheme. Results: Heterosexual sero-discordant couples were reluctant to the use of condoms consistently in addition to PrEP - because of the perception that PrEP alone was enough to protect them from HIV. Major motivations for PrEP use were to stay alive, stay negative, protect unborn children from acquiring HIV, and prevent sexual partners from acquiring HIV. Most couples expressed shock; fear and surprise when they learnt about their sero-discordant status. Negative partners reported a decline and change in sexual activities. Joint couple interviews revealed inconsistent condom use. Conclusion: Most respondents were motivated to use PrEP to stay negative or protect their sex partners from acquiring HIV. Condom use among newly diagnosed serodiscordant couples is motivated by concerns about infection. However, it appears that this declines with time as they become comfortable with the use of PrEP. Counseling on need for consistent condoms use in addition to PrEP should be emphasized for couples who opt for PrEP in resource limited settings.
Institution: Jos University Teaching Hospital
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W2952053098