Healthcare provider knowledge and attitudes about pre-exposure prophylaxis (PrEP) in pregnancy in Cape Town, South Africa

ABSTRACT

Pre-exposure prophylaxis (PrEP) in pregnancy can reduce HIV incidence and vertical transmission. Healthcare providers (HCPs) play a critical role in delivering PrEP in antenatal care but little is known about HCP knowledge and attitudes about PrEP in pregnancy. We conducted a qualitative study in two healthcare facilities to assess HCPs’ PrEP knowledge and perspectives relating to HIV prevention in pregnant women. Between January-March’19, we administered in-depth interviews among antenatal HCPs. We utilized a constant comparison approach to identify major qualitative findings. We enrolled 35 female HCPs (median age=43yrs. Fewer than half of HCPs had heard of PrEP before. Of those who had heard of PrEP, most felt that it was safe to take during pregnancy. Most HCPs described inaccurate PrEP knowledge regarding effectiveness, and most who knew about PrEP lacked clinical detail. HCPs highlighted important potential barriers to maternal PrEP use including: fear that PrEP may be unsafe, or belief that women must talk to partners/parents before initiating PrEP. Facilitators include good knowledge about serodiscordancy and vulnerability to seroconversion in pregnancy and desire to help women gain control overHIV prevention. We recommend integrating PrEP training into HIV testing and PMTCT nurse training to improve counseling and maternal PrEP delivery.

KEYWORDS:

• Pregnancy
• PMTCT
• PrEP
• HIV prevention
• South Africa
• healthcare providers

Acknowledgements

We would like to thank the providers that we interviewed for their time, as well as the study interviewers who collected the data.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Conflicts of interest

No conflicts of interest are declared by the authors.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

We received funding from the following sources: TC and LM, National Institute of Mental Health [grant number R01MH116771], DJD Fogarty International Center [grant number K01TW011187].