Male partners’ influence on women’s acceptance and use of PrEP products across two high HIV-burdened districts in South Africa

Abstract

The demonstrated efficacy of pre-exposure prophylaxis (PrEP) has brought hope of controlling the epidemic among women with limited HIV  preventation options. Several studies have demonstrated the importance of male partner involvement in female sexual and reproductive health but there is limited research on male involvement in the adoption of HIV prevention methods among women. Using a culture-centred approach, this article discusses perceptions of female-initiated HIV prevention methods among men and women. The data were collected using eight sex-specific focus group discussions with a sample of men and women aged between 18 and 49 years from selected urban and rural settings in two provinces of South Africa, KwaZulu-Natal and Mpumalanga. Thematic analysis was utilised to identify four key themes: increased infidelity in relationships and risky behaviour; association of PrEP with casual relationships; a partner’s right to know that women are reducing their risk of HIV infection; and that men need to engage in decision-making on HIV risk reduction. The article highlights the importance of partner engagement and knowledge sharing of female-initiated prevention methods as part of a combination HIV-prevention strategy, and the urgency of creating enabling environments to utilise female-initiated methods.

Keywords: female-initiated prevention methods, HIV prevention, male involvement, PrEP acceptance, women