BACKGROUND: HIV, WOMEN IN ESWATINI, PRE-EXPOSURE PROPHYLAXIS



Emphasizing Resilience to Promote PrEP among Swati WomenBACKGROUND: HIV, WOMEN IN ESWATINI, PRE-EXPOSURE PROPHYLAXIS Women in Eswatini experience some of the highest HIV acquisition rates globally, and have a higher risk of HIV incidence than Emaswati men. Women in Eswatini have to navigate many personal and cultural challenges before acting on health information. Pre-exposure prophylaxis (PrEP) for the prevention of HIV offers a discrete prevention method that is >90% effective. PrEP is recommended by the World Health Organization (WHO) as an additional HIV prevention choice. Starting in August 2017, PrEP has become available to the general public in a small number of government-run facilities as part of a demonstration project. Unlike in many countries, PrEP promotion in Eswatini does not target any specific population group. RESEARCH PURPOSEThis study sought to understand how PrEP was perceived by Swati women in order to inform PrEP promotion.WHAT THE RESEARCH TEAM DIDA team of scientists partnered with the Ministry of Health and the Clinton Health Access Initiative during the early introduction of PrEP. The team conducted in-depth interviews with 24 women who recently initiated PrEP and 30 stakeholders from HIV policy, implementation and donor sectors. WHAT THE RESEARCH TEAM FOUNDFemale clients and stakeholders described an environment of high HIV risk. Women felt PrEP enhanced their resilience by offering feelings of personal protection, control over HIV acquisition, choice in terms of when to take PrEP, enhanced sexual pleasure and relief from the fear of HIV and its consequences. The ability to take PrEP without partner knowledge was described by women as beneficial. PrEP helped women in this study envision a longer, healthier and more fulfilled life.RECOMMENDATIONSThe current, general population approach in terms of PrEP availability has many merits including that it mitigates an association of PrEP with a stigmatized group. However, it is essential to consider that different population types have different motivations for PrEP use. In relation to PrEP rollout and the inclusion of resilience-based messaging, our findings suggest that to reach women, a greater emphasis could be placed on how PrEP enhances sexual pleasure and intimacy, gives women control over HIV acquisition, provides relief from the fear of HIV infection (and its consequences), and promotes happiness in terms of watching children grow into adulthood. Focusing on PrEP solely as an HIV prevention method is factually correct, but fear-focused, and may not resonate as effectively with women.In light of the findings presented in this information brief, the research team recommends the following: Promote PrEP to women as a means to take ownership and control of HIV prevention choices.Ensure that PrEP is made available alongside sexual reproductive health services, including family planning and ante-natal services Highlight the sexual pleasure benefits of PrEP for men and women.Provide comprehensive PrEP information and counselling in communities to both women and men which highlight the benefits of PrEP alongside other prevention methods.305282613474700586476273611004751851158847009331294420011296652717800 ................
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