title: Gendered differences in the perceived risks and benefits of oral PrEP among HIV-serodiscordant couples in Kenya.
abstract: Pre-exposure prophylaxis (PrEP) is effective for preventing HIV among HIV-serodiscordant heterosexual couples. Gender roles may influence perceived personal and social risks related to HIV-prevention behaviors and may affect use of PrEP. In this study, interviews and focus groups were conducted with 68 individuals from 34 mutually disclosed serodiscordant heterosexual partnerships in Thika, Kenya. Sociocultural factors that affect adherence to PrEP were explored using grounded analysis. Three factors were identified, which shape perceptions of PrEP: gendered power dynamics and control over decision-making in the household; conflicts between risk-reduction strategies and male sexual desire; culture-bound definitions of women's work. Adherence to PrEP in the Partners PrEP Study was high; however, participants articulated conflicting interests related to PrEP in connection with traditional gender roles. The successful delivery of PrEP will require understanding of key social factors, particularly related to gender and dyadic dynamics around HIV serostatus.
authors.affiliation: a Department of Epidemiology , University of Washington , Seattle , Washington , USA.|b Department of Anthropology , University of Washington , Seattle , Washington , USA.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Carroll
authors.affiliation: c Department of Global Health , University of Washington , Seattle , Washington , USA.|e Jomo Kenyatta University of Agriculture and Technology , Nairobi , Kenya.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Ngure
authors.affiliation: a Department of Epidemiology , University of Washington , Seattle , Washington , USA.|c Department of Global Health , University of Washington , Seattle , Washington , USA.
authors.forename: Renee
authors.initials: R
authors.lastname: Heffron
authors.affiliation: a Department of Epidemiology , University of Washington , Seattle , Washington , USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Curran
authors.affiliation: f Kenya Medical Research Institute , Nairobi , Kenya.
authors.forename: Nelly R
authors.initials: NR
authors.lastname: Mugo
authors.affiliation: a Department of Epidemiology , University of Washington , Seattle , Washington , USA.|c Department of Global Health , University of Washington , Seattle , Washington , USA.|d Department of Medicine , University of Washington , Seattle , Washington , USA.
authors.forename: Jared M
authors.initials: JM
authors.lastname: Baeten
mesh_terms: D000284:Administration, Oral; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D005191:Family Characteristics; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000188:drug therapy* / Q000523:psychology / Q000635:transmission; D020010:Heterosexuality; D006801:Humans; D007407:Interviews as Topic; D007630:Kenya; D008297:Male; D010465:Perception; D065129:Pre-Exposure Prophylaxis; D018570:Risk Assessment; D012737:Sex Factors; D012747:Sexual Partners / Q000523:psychology
chemical_list: D019380:Anti-HIV Agents
keywords: HIV; Kenya; PrEP; antiretroviral therapy; heterosexual couples; qualitative