Women's experience with oral and vaginal pre-exposure prophylaxis: the VOICE-C qualitative study in Johannesburg, South Africa

Ariane van der Straten, Jonathan Stadler, Elizabeth Montgomery, Miriam Hartmann, Busiswe Magazi, Florence Mathebula, Katie Schwarz, Nicole Laborder, Lydia Soto-Torres PLoS ONE, 2014; doi: 10.1371/journal.pone.0089118 Women’s experience with oral and vaginal pre-exposure prophylaxis: the VOICE-C qualitative study in Johannesburg, South Africa

Socio-cultural and contextual factors influence people’s usage of prophylactic products. In VOICE, a multisite HIV pre-exposure prophylaxis (PrEP) trial, plasma drug levels pointed to widespread product non-use, despite high adherence estimated by self-reports and clinic product count.

Through in-depth interviews and focus-group discussions, the researchers found three themes that effect individuals’ product use:

  • ambivalence toward research
  • preserving a healthy status
  • managing social relationships

Few women reported lasting non-use, but many acknowledged occasionally missing doses because they were busy, forgot or feared side effects. Nearly all participants however, knew or heard of other study participants who did not use products daily.

The research community needs to acknowledge, and continuously remind itself, that new HIV preventatives will not be readily embraced just because they are needed. Only through a better understanding of the social and structural contexts in which these innovations are introduced can we perhaps facilitate the successful testing and adoption of efficacious bio-behavioural HIV prevention approaches that can be used by women.

 

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