When women’s HIV prevention becomes unstable
Findings from a longitudinal qualitative study in Sierra Leone
Bibliographic Data
| ID | 23310683 |
|---|---|
| Authors | Eric Nzirakaindi Ikoona (0000-0003-3402-1961, Public Health Agency, corresponding author), Lucy Namulemo (0000-0003-0594-2956, Training Programs in Epidemiology and Public Health Interventions Network), Ronald Kaluya (0000-0002-7577-0742, Counselling Centre for Children, Adolescents and Parents), Rebecca Ikoona (0009-0002-9821-9221, MUJHU Research Collaboration), Foday Sahr (0000-0001-9816-4502, Public Health Agency) |
| Year | 2026 |
| Pages | 1-13 |
| Publication date | 2026-07-22 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Culture Health & Sexuality (JOURNAL) |
| Journal identifiers | ISSN: 1369-1058 • E-ISSN: 1464-5351 |
| Publisher | Informa UK Limited (PUBLISHER • GB) |
| DOI | 10.1080/13691058.2026.2706642 |
| PMID | 42485086 |
| OpenAlex | W7170076035 |
| Language | EN |
| References cited | 23 |
HIV prevention among women is often described as movement from risk recognition to protective action. Structural and gender factors shape whether that movement occurs. Less clear is how these factors change over time and how these changes affect women’s capacity to sustain prevention. This longitudinal qualitative study examined this temporal gap in Sierra Leone. Forty-eight interviews were conducted across Western Area Urban, Bo and Kenema. They included women who were re-interviewed 12 months after a parent study, male participants recruited through female-partner referral or HIV community networks, and community health workers. Data were analysed using thematic analysis, trajectory comparison and a typology of male partner orientations. Women who previously discussed HIV testing or negotiated protection could lose this capacity when income, relational safety or partner support deteriorated; others rebuilt it through income, osusu participation, service contact and social support. Analysis of male participants’ accounts identified three male partner orientations in relation to women’s HIV prevention: protective complicity, dismissive gatekeeping, and fearful avoidance. Structural instability emerged as a useful analytic lens for understanding changing enabling conditions. Prevention programmes may need to protect women’s privacy, reduce economic and relationship barriers and keep services accessible, rather than assume one-time behaviour change will last.
Health services · Human immunodeficiency virus (HIV) · Longitudinal study · Population · Qualitative property · Qualitative research · Sierra leone · Social issues · Adolescent Sexual and Reproductive Health · Global Maternal and Child Health · HIV/AIDS Research and Interventions
Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa
Structural approaches to HIV prevention
Thematic Analysis
Defining success with HIV pre-exposure prophylaxis
Application of the Theory of Gender and Power to Examine HIV-Related Exposures, Risk Factors, and Effective Interventions for Women
Towards an Understanding of Risk Behavior
Intimate partner violence, relationship power inequity, and incidence of HIV infection in young women in South Africa
Consolidated criteria for reporting qualitative research (Coreq)
Towards a “fourth generation” of approaches to HIV/Aids management
“Protecting ourselves in silence”
Seasons of Risk
The ‘risk environment’
Structural Vulnerability and Health
| Citation velocity | historical |
|---|---|
| Highly cited | No |