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How gender norms and ‘good girl’ notions prevent adolescent girls and young women from engaging with PrEP: qualitative insights from Zimbabwe

BACKGROUND: Pre-exposure prophylaxis, or PrEP, has been hailed for its promise to provide women with user-control. However, gender-specific challenges undermining PrEP use are beginning to emerge. We explore the role of gender norms in shaping adolescent girls and young women’s (AGYW) engagement wit...

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Autores principales: Skovdal, Morten, Clausen, Camilla Lysemose, Magoge-Mandizvidza, Phyllis, Dzamatira, Freedom, Maswera, Rufurwokuda, Nyamwanza, Rangarirayi Primrose, Nyamukapa, Constance, Thomas, Ranjeeta, Gregson, Simon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9379870/
https://www.ncbi.nlm.nih.gov/pubmed/35974360
http://dx.doi.org/10.1186/s12905-022-01928-2
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author Skovdal, Morten
Clausen, Camilla Lysemose
Magoge-Mandizvidza, Phyllis
Dzamatira, Freedom
Maswera, Rufurwokuda
Nyamwanza, Rangarirayi Primrose
Nyamukapa, Constance
Thomas, Ranjeeta
Gregson, Simon
author_facet Skovdal, Morten
Clausen, Camilla Lysemose
Magoge-Mandizvidza, Phyllis
Dzamatira, Freedom
Maswera, Rufurwokuda
Nyamwanza, Rangarirayi Primrose
Nyamukapa, Constance
Thomas, Ranjeeta
Gregson, Simon
author_sort Skovdal, Morten
collection PubMed
description BACKGROUND: Pre-exposure prophylaxis, or PrEP, has been hailed for its promise to provide women with user-control. However, gender-specific challenges undermining PrEP use are beginning to emerge. We explore the role of gender norms in shaping adolescent girls and young women’s (AGYW) engagement with PrEP. METHODS: We draw on qualitative data from 12 individual interviews and three focus group discussions with AGYW from eastern Zimbabwe. Interviews were transcribed and thematically coded in NVivo 12. Emerging themes were further investigated using Connell’s notion of ‘emphasised femininity’. RESULTS: Participants alluded to the patriarchal society they are part of, with ‘good girl’ notions subjecting them to direct and indirect social control. These controls manifest themselves through the anticipation of intersecting sexuality- and PrEP-related stigmas, discouraging AGYW from engaging with PrEP. AGYW recounted the need for permission to engage with PrEP, forcing them to consider engaging with PrEP in secrecy. In addition, limited privacy at home, and fear of disclosure of their health clinic visits, further heightened their fear of engaging with PrEP. PrEP is not simply a user-controlled HIV prevention method, but deeply entrenched within public gender orders. CONCLUSION: AGYW face significant limitations in their autonomy to initiate and engage with PrEP. Those considering PrEP face the dilemma of Scylla and Charybdis: The social risks of stigmatisation or risks of HIV acquisition. Efforts to make PrEP available must form part of a combination of social and structural interventions that challenge harmful gender norms. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12905-022-01928-2.
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spelling pubmed-93798702022-08-16 How gender norms and ‘good girl’ notions prevent adolescent girls and young women from engaging with PrEP: qualitative insights from Zimbabwe Skovdal, Morten Clausen, Camilla Lysemose Magoge-Mandizvidza, Phyllis Dzamatira, Freedom Maswera, Rufurwokuda Nyamwanza, Rangarirayi Primrose Nyamukapa, Constance Thomas, Ranjeeta Gregson, Simon BMC Womens Health Research BACKGROUND: Pre-exposure prophylaxis, or PrEP, has been hailed for its promise to provide women with user-control. However, gender-specific challenges undermining PrEP use are beginning to emerge. We explore the role of gender norms in shaping adolescent girls and young women’s (AGYW) engagement with PrEP. METHODS: We draw on qualitative data from 12 individual interviews and three focus group discussions with AGYW from eastern Zimbabwe. Interviews were transcribed and thematically coded in NVivo 12. Emerging themes were further investigated using Connell’s notion of ‘emphasised femininity’. RESULTS: Participants alluded to the patriarchal society they are part of, with ‘good girl’ notions subjecting them to direct and indirect social control. These controls manifest themselves through the anticipation of intersecting sexuality- and PrEP-related stigmas, discouraging AGYW from engaging with PrEP. AGYW recounted the need for permission to engage with PrEP, forcing them to consider engaging with PrEP in secrecy. In addition, limited privacy at home, and fear of disclosure of their health clinic visits, further heightened their fear of engaging with PrEP. PrEP is not simply a user-controlled HIV prevention method, but deeply entrenched within public gender orders. CONCLUSION: AGYW face significant limitations in their autonomy to initiate and engage with PrEP. Those considering PrEP face the dilemma of Scylla and Charybdis: The social risks of stigmatisation or risks of HIV acquisition. Efforts to make PrEP available must form part of a combination of social and structural interventions that challenge harmful gender norms. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12905-022-01928-2. BioMed Central 2022-08-16 /pmc/articles/PMC9379870/ /pubmed/35974360 http://dx.doi.org/10.1186/s12905-022-01928-2 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Skovdal, Morten
Clausen, Camilla Lysemose
Magoge-Mandizvidza, Phyllis
Dzamatira, Freedom
Maswera, Rufurwokuda
Nyamwanza, Rangarirayi Primrose
Nyamukapa, Constance
Thomas, Ranjeeta
Gregson, Simon
How gender norms and ‘good girl’ notions prevent adolescent girls and young women from engaging with PrEP: qualitative insights from Zimbabwe
title How gender norms and ‘good girl’ notions prevent adolescent girls and young women from engaging with PrEP: qualitative insights from Zimbabwe
title_full How gender norms and ‘good girl’ notions prevent adolescent girls and young women from engaging with PrEP: qualitative insights from Zimbabwe
title_fullStr How gender norms and ‘good girl’ notions prevent adolescent girls and young women from engaging with PrEP: qualitative insights from Zimbabwe
title_full_unstemmed How gender norms and ‘good girl’ notions prevent adolescent girls and young women from engaging with PrEP: qualitative insights from Zimbabwe
title_short How gender norms and ‘good girl’ notions prevent adolescent girls and young women from engaging with PrEP: qualitative insights from Zimbabwe
title_sort how gender norms and ‘good girl’ notions prevent adolescent girls and young women from engaging with prep: qualitative insights from zimbabwe
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9379870/
https://www.ncbi.nlm.nih.gov/pubmed/35974360
http://dx.doi.org/10.1186/s12905-022-01928-2
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