Women’s Sociocultural Representations of HIV Pre-Exposure Prophylaxis and Intimate Partner Violence in Heterosexual Relationships: A Qualitative Story Method
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Objective
The current study sought to assess women’s understanding of pre-exposure prophylaxis interest and initiation in heterosexually-active relationships with and without histories of intimate partner violence.
Design
2017-18 prospective cohort study with an embedded, story completion exercise in the 90-day follow-up such that participants were randomized to receive one of two versions of a story stem based on whether they experienced intimate partner violence.
Setting
Connecticut.
Participants
132 heterosexually-active, cisgender adult women residing in the state of Connecticut.
Primary outcomes measures
Our primary outcome included identifying principal narratives that describes women’s conceptualizations of pre-exposure prophylaxis interest and initiation in heterosexually-active relationships.
Results
Using both story mapping and thematic analysis techniques, four principal narratives were identified across the stories: 1) the Informed and Empowered PrEP User , 2) the Clandestine PrEP User , 3) the Hesitant PrEP Contemplator , and 4) the Disenfranchised PrEP Non-User . These novel narratives provide insights on how social, clinical, and interpersonal factors are underpinning heterosexually-active, cisgender adult women’s ability to display interest and initiate pre-exposure prophylaxis in their relationships.
Conclusions
If our findings are replicated in studies in different settings, it will provide substantial support for future prevention interventions adopting empowerment-centered approaches to refocus women’s needs in the context of PrEP initiation and healthy relationships.
