Understanding PrEP misconceptions and their impact on PrEP initiation and use among pregnant and lactating women in Malawi

Bibliographic Data

ID19591809
AuthorsAlinda M Young (0000-0001-9277-967X, University of North Carolina at Chapel Hill, corresponding author), Marley Catlett (University of North Carolina at Chapel Hill, corresponding author), Friday Saidi (0000-0003-1190-1499, University of North Carolina at Chapel Hill, corresponding author), Twambilile Phanga (0000-0002-9519-7672, corresponding author), Jennifer Tseka (corresponding author), Agatha Bula (0000-0001-8440-7059, corresponding author), Lisa D Pearce (0000-0001-6210-863X, University of North Carolina at Chapel Hill, corresponding author), Suzanne Maman (0000-0003-4048-1585, University of North Carolina at Chapel Hill, corresponding author), Carol E Golin (0000-0002-5546-3163, University of North Carolina at Chapel Hill, corresponding author), W Mutale (0000-0002-4891-6750, University of Zambia, corresponding author), Benjamin H Chi (University of North Carolina at Chapel Hill, corresponding author), Lauren M Hill (0000-0001-9444-4435, University of North Carolina at Chapel Hill, corresponding author)
EditorsAmy Huei-Yi Lee
Year2025
Volume5
Issue5
Pagese0004667
Publication date2025-05-27
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0004667
PMID40424215
OpenAlexW4410772718
LanguageEN
Citations received1
References cited52

Mother-to-child transmission (MTCT) of HIV remains a challenge in Eastern and Southern Africa. Oral pre-exposure prophylaxis (PrEP) is a powerful tool to reduce MTCT, but women face barriers to effective use including those related to inaccurate comprehension of PrEP To understand women’s misconceptions about PrEP and their potential impact on PrEP use, we conducted interviews with 33 pregnant and lactating women in Malawi using PrEP, and ten PrEP counselors and clinicians. The results indicate that, although pregnant women generally understood PrEP’s features and functions, many held misconceptions that persisted over the course of their PrEP use and impacted their perceptions and use of the medication. Some women erroneously believed that PrEP could treat and prevent sexually transmitted infections other than HIV, which motivated some to keep taking PrEP while motivating others to stop using PrEP once their STI had resolved. Some were confused about PrEP’s function, with some believing it was the same as antiretroviral therapy for HIV treatment, and others believing that PrEP could be used for overall enhancement of health. Rarer misconceptions included fears that PrEP was connected to satanic practices, could cause cancer, or was solely for individuals engaged in sex work. These misconceptions stemmed from a mix of prior knowledge, societal influences, and miscommunications during counseling sessions. Ensuring accurate knowledge and addressing common misconceptions head-on is crucial to promote continued PrEP use among women. Both clinic- and community-based communication efforts with a particular focus on the difference between PrEP, STI treatments, and ART are needed

Alternative medicine · Comprehension · Family medicine · Men who have sex with men · Pre-exposure prophylaxis · Adolescent Sexual and Reproductive Health · HIV/AIDS Research and Interventions · Medicine · Psychology · Sex work and related issues