Barriers to Oral HIV Pre-exposure Prophylaxis (PrEP) Adherence Among Pregnant and Post-partum Women from Cape Town, South Africa

Cisgender women, particularly pregnant and postpartum women in Eastern and Southern Africa, face an unacceptably high risk of HIV acquisition. Oral pre-exposure prophylaxis (PrEP) is an effective HIV prevention intervention that can reduce HIV acquisition and vertical transmission. In this qualitati...

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Bibliographic Details
Published inAIDS and behavior Vol. 26; no. 9; pp. 3079 - 3087
Main Authors Beesham, Ivana, Dovel, Kathryn, Mashele, Nyiko, Bekker, Linda-Gail, Gorbach, Pamina, Coates, Thomas J., Myer, Landon, Joseph Davey, Dvora Leah
Format Journal Article
LanguageEnglish
Published New York Springer US 01.09.2022
Springer Nature B.V
Subjects
Barriers
Breastfeeding & lactation
Cisgender
Disease prevention
Disease transmission
Health Psychology
Health risks
HIV
Human immunodeficiency virus
Infectious Diseases
Logistics
Medicine
Medicine & Public Health
Original Paper
Patient compliance
Postpartum
Postpartum period
Pregnancy
Prophylaxis
Public Health
Qualitative research
Side effects
Women
Womens health
South Africa
Cape Town South Africa
Adherence
Persistence
Pre-exposure prophylaxis (PrEP)
Pregnant
South Africa
Breastfeeding
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Summary:Cisgender women, particularly pregnant and postpartum women in Eastern and Southern Africa, face an unacceptably high risk of HIV acquisition. Oral pre-exposure prophylaxis (PrEP) is an effective HIV prevention intervention that can reduce HIV acquisition and vertical transmission. In this qualitative study, we interviewed 21 postpartum women from Cape Town, South Africa who initiated PrEP during pregnancy and who self-reported low PrEP adherence or missed > 1 PrEP follow-up collection. We identified multiple overlapping barriers to PrEP continuation and/or adherence. Individual factors included forgetting to take PrEP daily, being away from home when PrEP should be taken, anticipated stigma and limited disclosure of PrEP use. Women also reported pill-related factors such as side effects and having to take PrEP in addition to other tablets during pregnancy and the postpartum period. Facility-related barriers included logistics around PrEP collection especially when not in antenatal care, as well as transport and financial barriers.
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ISSN:1090-7165
1573-3254
DOI:10.1007/s10461-022-03652-2