Exploring Preferences for Long-Acting Injectable PrEP Among Postpartum Women in South Africa Using the Consolidated Framework for Implementation Research
The Siphila Sonke Study
Bibliographic Data
South African women are disproportionately affected by HIV, with increased incidence during pregnancy and postpartum. While oral TDF/FTC pre-exposure prophylaxis (PrEP) is safe, effective, and recommended for pregnant and postpartum women, adherence to a daily pill is challenging, particularly during the postpartum period. Longer-acting injectable (LAI) PrEP products may be more desirable for postpartum women however, limited data on factors influencing uptake are available to inform roll-out of LAI products among postpartum women. Using the Consolidated Framework for Implementation Research (CFIR), we explored LAI PrEP implementation determinants among postpartum women in South Africa. From March-April 2023, 4 focus group discussions (FGDs) were conducted among postpartum women in KwaZulu-Natal. A directed content analysis method was performed. Among 23 women, median age was 27 (range 19–36) years. Two (9%) reported a pregnancy partner living with HIV, 7 (30%) had ever used PrEP, and 21 (91%) had ever breastfed. Factors that may influence LAI PrEP implementation are organized by three CFIR domains. Individuals expressed interest in and potential willingness to use LAI PrEP, but limited knowledge. At the implementation process domain, participants perceived LAI-PrEP users to have high HIV risk perception, and were themselves worried about side-effects, access, and fear of partner conflict. They also identified implementation opportunities including peer PrEP mentors, mobile clinics, and community clinic integration. At the outer setting, cultural beliefs/practices during postpartum were important determinants. Our findings indicate interest and willingness to consider LAI PrEP among postpartum women and highlight implementation opportunities to reduce HIV acquisition and perinatal transmission.
Focus group · Health psychology · Pill · Postpartum period · Pre-exposure prophylaxis · Pregnancy · Public health · Adolescent Sexual and Reproductive Health · Health Policy Implementation Science · HIV/AIDS Research and Interventions
The updated Consolidated Framework for Implementation Research based on user feedback
Fostering implementation of health services research findings into practice
Consolidated criteria for reporting qualitative research (Coreq)
“She is the one who knows”
“Dream PrEP delivery package”
Improved rates of exclusive breastfeeding at 14 weeks of age in KwaZulu Natal, South Africa
Facilitators and barriers to HIV pre-exposure prophylaxis (PrEP) uptake through a community-based intervention strategy among adolescent girls and young women in Seme Sub-County, Kisumu, Kenya
PrEP reminds me that I am the one to take responsibility of my life
Delivering PrEP to Young Women in a Low-Income Setting in South Africa
Sexual Attitudes, Beliefs, Practices, and HIV Risk During Pregnancy and Post-delivery
Trajectories of PrEP Adherence Among Young Women Aged 16 to 25 in Cape Town, South Africa
Two Decades of Developments in Qualitative Inquiry
Three Approaches to Qualitative Content Analysis
Contraceptive trajectories postpartum
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| Highly cited | No |