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Relationship dynamics and anticipated stigma: Key considerations for PrEP use among Tanzanian adolescent girls and young women and male partners

OBJECTIVES: We examined key gender, interpersonal and community dynamics influencing PrEP acceptability among adolescent girls and young women (AGYW) and their male partners. METHODS: We administered 12 in-depth interviews (IDI) to partnered, or married AGYW aged 15–24 years living without HIV, and...

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Autores principales: Jani, Nrupa, Mathur, Sanyukta, Kahabuka, Catherine, Makyao, Neema, Pilgrim, Nanlesta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7888654/
https://www.ncbi.nlm.nih.gov/pubmed/33596216
http://dx.doi.org/10.1371/journal.pone.0246717
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author Jani, Nrupa
Mathur, Sanyukta
Kahabuka, Catherine
Makyao, Neema
Pilgrim, Nanlesta
author_facet Jani, Nrupa
Mathur, Sanyukta
Kahabuka, Catherine
Makyao, Neema
Pilgrim, Nanlesta
author_sort Jani, Nrupa
collection PubMed
description OBJECTIVES: We examined key gender, interpersonal and community dynamics influencing PrEP acceptability among adolescent girls and young women (AGYW) and their male partners. METHODS: We administered 12 in-depth interviews (IDI) to partnered, or married AGYW aged 15–24 years living without HIV, and 16 IDIs to male partners living without HIV aged 18 or older, partnered or married to an AGYW in Tanzania. Card sorting, a participatory qualitative method for facilitating systematic discussion, was used to identify attitudes, values, and desires that would influence PrEP acceptability. RESULTS: Relationship distrust, partner communication about HIV risk, and need to control HIV risk were highly influential considerations for PrEP use. AGYW and male partners both wanted to discuss PrEP use amidst relationship distrust, while most male partners encouraged AGYW PrEP use for shared protective benefit. Anticipated stigma of being perceived as a person living with HIV, as a result of PrEP use, was a deterrent for both AGYW and male partners while AGYW also feared additional stigma of being considered sexually promiscuous. CONCLUSIONS: Couples counseling for PrEP uptake and adherence might be a well-placed strategy for couples who are living without HIV to educate one another about the relationship benefits of using PrEP, thereby increasing its acceptance and adherence, addressing unequal power dynamics, and reducing associated relationship distrust. Community awareness and education about PrEP can help curb persistent PrEP stigma, including intersectional stigma.
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spelling pubmed-78886542021-02-25 Relationship dynamics and anticipated stigma: Key considerations for PrEP use among Tanzanian adolescent girls and young women and male partners Jani, Nrupa Mathur, Sanyukta Kahabuka, Catherine Makyao, Neema Pilgrim, Nanlesta PLoS One Research Article OBJECTIVES: We examined key gender, interpersonal and community dynamics influencing PrEP acceptability among adolescent girls and young women (AGYW) and their male partners. METHODS: We administered 12 in-depth interviews (IDI) to partnered, or married AGYW aged 15–24 years living without HIV, and 16 IDIs to male partners living without HIV aged 18 or older, partnered or married to an AGYW in Tanzania. Card sorting, a participatory qualitative method for facilitating systematic discussion, was used to identify attitudes, values, and desires that would influence PrEP acceptability. RESULTS: Relationship distrust, partner communication about HIV risk, and need to control HIV risk were highly influential considerations for PrEP use. AGYW and male partners both wanted to discuss PrEP use amidst relationship distrust, while most male partners encouraged AGYW PrEP use for shared protective benefit. Anticipated stigma of being perceived as a person living with HIV, as a result of PrEP use, was a deterrent for both AGYW and male partners while AGYW also feared additional stigma of being considered sexually promiscuous. CONCLUSIONS: Couples counseling for PrEP uptake and adherence might be a well-placed strategy for couples who are living without HIV to educate one another about the relationship benefits of using PrEP, thereby increasing its acceptance and adherence, addressing unequal power dynamics, and reducing associated relationship distrust. Community awareness and education about PrEP can help curb persistent PrEP stigma, including intersectional stigma. Public Library of Science 2021-02-17 /pmc/articles/PMC7888654/ /pubmed/33596216 http://dx.doi.org/10.1371/journal.pone.0246717 Text en © 2021 Jani et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Jani, Nrupa
Mathur, Sanyukta
Kahabuka, Catherine
Makyao, Neema
Pilgrim, Nanlesta
Relationship dynamics and anticipated stigma: Key considerations for PrEP use among Tanzanian adolescent girls and young women and male partners
title Relationship dynamics and anticipated stigma: Key considerations for PrEP use among Tanzanian adolescent girls and young women and male partners
title_full Relationship dynamics and anticipated stigma: Key considerations for PrEP use among Tanzanian adolescent girls and young women and male partners
title_fullStr Relationship dynamics and anticipated stigma: Key considerations for PrEP use among Tanzanian adolescent girls and young women and male partners
title_full_unstemmed Relationship dynamics and anticipated stigma: Key considerations for PrEP use among Tanzanian adolescent girls and young women and male partners
title_short Relationship dynamics and anticipated stigma: Key considerations for PrEP use among Tanzanian adolescent girls and young women and male partners
title_sort relationship dynamics and anticipated stigma: key considerations for prep use among tanzanian adolescent girls and young women and male partners
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7888654/
https://www.ncbi.nlm.nih.gov/pubmed/33596216
http://dx.doi.org/10.1371/journal.pone.0246717
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