‘I’m waiting for that’: Interest in the use of PrEP for safer conception in Botswana

ABSTRACT

Safe and effective low-cost safer conception (SC) methods are increasingly available and being integrated into national guidelines in sub-Saharan African contexts. Sero-different couples of childbearing age can benefit from such services and the routine provision of SC counselling. Pre-exposure prophylaxis (PrEP) to prevent HIV acquisition to uninfected partners can reduce the chances of HIV transmission when trying to achieve pregnancy. Botswana has a strong commitment to reducing new HIV infections but PrEP is not yet widely available and little guidance has been offered on counselling sero-different couples. We conducted qualitative in-depth interviews in Gaborone, Botswana with 10 HIV healthcare providers and 10 women living with HIV of childbearing age because they act as a key conduit for reaching sero-different partners with information about PrEP. We examined knowledge and attitudes towards PrEP to assess the viability and develop a deeper understanding of this SC option. Interviews were analysed using an interpretive phenomenological approach. Three themes emerged: (1) awareness of PrEP is limited, (2) providers and women overwhelmingly showed interest in PrEP and (3) women living with HIV and providers have concerns about PrEP use. With the correct support, PrEP could be a useful SC option for sero-different couples in Botswana and other sub-Saharan contexts.

KEYWORDS:

• PrEP
• safer conception
• Botswana

Acknowledgements

The authors would like to extend their heartfelt thanks to the women living with HIV and providers in Botswana who gave their valuable time and input to this study. The authors would also like to acknowledge the Botswana Ministry of Health for their support of this research.

Disclosure statement

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

Data availability

The dataset generated and analysed during the current study are available from the corresponding author on reasonable request.

Additional information

Funding

This study would not have been possible without the generous financial support of various schools and institutes at the University of Michigan including the International Institute, the African Studies Center, the Office of Global Public Health at the School of Public Health, and the Rackham Graduate School. This research was also supported in part by an NICHD training grant to the Population Studies Center at the University of Michigan [grant number T32 HD007339] and by the National Institutes of Mental Health of the U.S. Public Health Service [grant number T32 MH19105]. None of the funders mentioned here played any role in the design of the study, data collection, analysis, interpretation of data, or manuscript writing.