title: Lay Social Resources for Support of Adherence to Antiretroviral Prophylaxis for HIV Prevention Among Serodiscordant Couples in sub-Saharan Africa: A Qualitative Study.
abstract: Effectiveness of antiretroviral pre-exposure prophylaxis (PrEP) for HIV prevention will require high adherence. Using qualitative data, this paper identifies potential lay social resources for support of PrEP adherence by HIV serodiscordant couples in Uganda, laying the groundwork for incorporation of these resources into adherence support initiatives as part of implementation. The qualitative analysis characterizes support for PrEP adherence provided by HIV-infected spouses, children, extended family members, and the larger community. Results suggest social resources for support of PrEP adherence in Africa are plentiful outside formal health care settings and health systems and that couples will readily use them. The same shortage of health professionals that impeded scale-up of antiretroviral treatment for HIV/AIDS in Africa promises to challenge delivery of PrEP. Building on the treatment scale-up experience, implementers can address this challenge by examining the value of lay social resources for adherence support in developing strategies for delivery of PrEP.
authors.affiliation: Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Ave., Boston, MA, USA, norma_ware@hms.harvard.edu.
authors.forename: Norma C
authors.initials: NC
authors.lastname: Ware
authors.forename: Emily E
authors.initials: EE
authors.lastname: Pisarski
authors.forename: Jessica E
authors.initials: JE
authors.lastname: Haberer
authors.forename: Monique A
authors.initials: MA
authors.lastname: Wyatt
authors.forename: Elioda
authors.initials: E
authors.lastname: Tumwesigye
authors.forename: Jared M
authors.initials: JM
authors.lastname: Baeten
authors.forename: Connie L
authors.initials: CL
authors.lastname: Celum
authors.forename: David R
authors.initials: DR
authors.lastname: Bangsberg
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000188:drug therapy* / Q000523:psychology / Q000635:transmission; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence; D015999:Multivariate Analysis; D065129:Pre-Exposure Prophylaxis / Q000379:methods*; D036301:Qualitative Research; D012044:Regression Analysis; D012747:Sexual Partners / Q000523:psychology; D012944:Social Support; D014454:Uganda
chemical_list: D019380:Anti-HIV Agents