Human immunodeficiency virus (HIV) infection during pregnancy and breastfeeding can impact maternal health. Therefore, a study published in PloS One explored the prospective acceptability of two novel HIV pre-exposure prophylaxis (PrEP) products—oral pills and vaginal rings—through focus group discussions with pregnant and breastfeeding women in Sub Saharan African.

The study took place between May to November 2018, and included 65 pregnant and breastfeeding women in Malawi, South Africa, Uganda, and Zimbabwe. Qualitative analysis was completed using the Theoretical Framework of Acceptability (TFA). The researchers assessed seven TFA constructs (Affective Attitude; Burden; Ethicality; Intervention Coherence; Opportunity Costs; Perceived Effectiveness; Self-efficacy). Subsequently, an iterative analysis was conducted to generate themes within each of the TFA constructs.

According to the results, women showed positive attitudes towards daily oral PrEP, which highlighted the familiarity of taking pills, understanding the purpose of taking pills, and the perception that it is an effective method to protect mothers and babies from HIV during pregnancy and breastfeeding. The investigators noted that women emphasized the ease of using the ring given its monthly duration that lowers burden on the user.

The researchers concluded that this TFA analysis, “highlighted how acceptability of both methods could be enhanced by focusing on perceptions of the end users (i.e., the women) and not just the products themselves This approach provided insights into how to refine the intervention materials and plans for implementation.”



Keywords: HIV infection, breastfeeding, HIV Pre-exposure Prophylaxis (PrEP) products, oral pills, and vaginal rings