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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| Published in | AIDS and behavior Vol. 26; no. 9; pp. 3079 - 3087 |
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| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
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New York
Springer US
01.09.2022
Springer Nature B.V |
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| Abstract | 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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| AbstractList | 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. Abstract 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. |
| Author | Dovel, Kathryn Gorbach, Pamina Bekker, Linda-Gail Myer, Landon Mashele, Nyiko Joseph Davey, Dvora Leah Beesham, Ivana Coates, Thomas J. |
| Author_xml | – sequence: 1 givenname: Ivana orcidid: 0000-0003-4889-8123 surname: Beesham fullname: Beesham, Ivana email: i_beesham@yahoo.com organization: Desmond Tutu Health Foundation, University of Cape Town, Level One, Wernher Beit North, University of Cape Town (UCT), Faculty of Health Sciences – sequence: 2 givenname: Kathryn surname: Dovel fullname: Dovel, Kathryn organization: Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles – sequence: 3 givenname: Nyiko surname: Mashele fullname: Mashele, Nyiko organization: Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town – sequence: 4 givenname: Linda-Gail surname: Bekker fullname: Bekker, Linda-Gail organization: Desmond Tutu Health Foundation, University of Cape Town – sequence: 5 givenname: Pamina surname: Gorbach fullname: Gorbach, Pamina organization: Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles – sequence: 6 givenname: Thomas J. surname: Coates fullname: Coates, Thomas J. organization: Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles – sequence: 7 givenname: Landon surname: Myer fullname: Myer, Landon organization: Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town – sequence: 8 givenname: Dvora Leah surname: Joseph Davey fullname: Joseph Davey, Dvora Leah organization: Desmond Tutu Health Foundation, University of Cape Town, Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles |
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| Keywords | Adherence Persistence Pre-exposure prophylaxis (PrEP) Pregnant South Africa Breastfeeding |
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| Snippet | Cisgender women, particularly pregnant and postpartum women in Eastern and Southern Africa, face an unacceptably high risk of HIV acquisition. Oral... Abstract Cisgender women, particularly pregnant and postpartum women in Eastern and Southern Africa, face an unacceptably high risk of HIV acquisition. Oral... |
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| SubjectTerms | 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 |
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| Title | Barriers to Oral HIV Pre-exposure Prophylaxis (PrEP) Adherence Among Pregnant and Post-partum Women from Cape Town, South Africa |
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