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Experiences Using Pre-Exposure Prophylaxis for Safer Conception Among HIV Serodiscordant Heterosexual Couples in the United States.
AIDS Patient Care STDS. 2017 08; 31(8):348-355.AP

Abstract

Antiretroviral pre-exposure prophylaxis (PrEP) is a promising HIV prevention strategy for HIV serodiscordant couples (HIV-infected male, uninfected female) seeking safer conception. However, most research on PrEP for safer conception has focused on couples in sub-Saharan Africa; little is known about the perspectives or experiences of heterosexual couples in the United States. We conducted qualitative interviews with six couples (six women and five of their male partners) receiving PrEP for conception services at an urban safety net hospital in the US Northeast. In-depth interview guides explored couple relationships and contextual factors and attitudes, perceptions, and decision-making processes surrounding PrEP for safer conception. Thematic analyses focused on identifying the following emergent themes. We found that couple relationships were situated within broader social and cultural contexts of immigration, family, and community that shaped their experiences with HIV and serodiscordant relationship status. Despite strong partner support within relationships, HIV stigma and disapproval of serodiscordant relationships contributed to couples' feelings of social isolation and subsequent aspirations to have "normal" families. By enabling "natural" conception through condomless sex, PrEP for safer conception provided a sense of enhanced relationship intimacy. Couples called for increasing public awareness of PrEP through positive messaging as a way to combat HIV stigma. Findings suggest that relationship dynamics and broader social contexts appear to shape HIV serodiscordant couples' fertility desires and motivations to use PrEP. However, increased public awareness of PrEP for safer conception may be needed to combat HIV stigma at the community level.

Authors+Show Affiliations

1 Department of Community Health Sciences, Boston University School of Public Health , Boston, Massachusetts.2 Department of Health Law, Policy & Management, Boston University School of Public Health , Boston, Massachusetts. 3 Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies , Tufts Medical Center, Boston, Massachusetts.2 Department of Health Law, Policy & Management, Boston University School of Public Health , Boston, Massachusetts.4 Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine , Boston, Massachusetts.2 Department of Health Law, Policy & Management, Boston University School of Public Health , Boston, Massachusetts. 4 Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine , Boston, Massachusetts. 5 Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital , Bedford, Massachusetts.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28719229

Citation

Bazzi, Angela R., et al. "Experiences Using Pre-Exposure Prophylaxis for Safer Conception Among HIV Serodiscordant Heterosexual Couples in the United States." AIDS Patient Care and STDs, vol. 31, no. 8, 2017, pp. 348-355.
Bazzi AR, Leech AA, Biancarelli DL, et al. Experiences Using Pre-Exposure Prophylaxis for Safer Conception Among HIV Serodiscordant Heterosexual Couples in the United States. AIDS Patient Care STDS. 2017;31(8):348-355.
Bazzi, A. R., Leech, A. A., Biancarelli, D. L., Sullivan, M., & Drainoni, M. L. (2017). Experiences Using Pre-Exposure Prophylaxis for Safer Conception Among HIV Serodiscordant Heterosexual Couples in the United States. AIDS Patient Care and STDs, 31(8), 348-355. https://doi.org/10.1089/apc.2017.0098
Bazzi AR, et al. Experiences Using Pre-Exposure Prophylaxis for Safer Conception Among HIV Serodiscordant Heterosexual Couples in the United States. AIDS Patient Care STDS. 2017;31(8):348-355. PubMed PMID: 28719229.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Experiences Using Pre-Exposure Prophylaxis for Safer Conception Among HIV Serodiscordant Heterosexual Couples in the United States. AU - Bazzi,Angela R, AU - Leech,Ashley A, AU - Biancarelli,Dea L, AU - Sullivan,Meg, AU - Drainoni,Mari-Lynn, Y1 - 2017/07/18/ PY - 2017/7/19/pubmed PY - 2017/11/29/medline PY - 2017/7/19/entrez KW - HIV prevention KW - conception KW - fertility KW - heterosexual couples KW - pre-exposure prophylaxis KW - serodiscordant couples SP - 348 EP - 355 JF - AIDS patient care and STDs JO - AIDS Patient Care STDS VL - 31 IS - 8 N2 - Antiretroviral pre-exposure prophylaxis (PrEP) is a promising HIV prevention strategy for HIV serodiscordant couples (HIV-infected male, uninfected female) seeking safer conception. However, most research on PrEP for safer conception has focused on couples in sub-Saharan Africa; little is known about the perspectives or experiences of heterosexual couples in the United States. We conducted qualitative interviews with six couples (six women and five of their male partners) receiving PrEP for conception services at an urban safety net hospital in the US Northeast. In-depth interview guides explored couple relationships and contextual factors and attitudes, perceptions, and decision-making processes surrounding PrEP for safer conception. Thematic analyses focused on identifying the following emergent themes. We found that couple relationships were situated within broader social and cultural contexts of immigration, family, and community that shaped their experiences with HIV and serodiscordant relationship status. Despite strong partner support within relationships, HIV stigma and disapproval of serodiscordant relationships contributed to couples' feelings of social isolation and subsequent aspirations to have "normal" families. By enabling "natural" conception through condomless sex, PrEP for safer conception provided a sense of enhanced relationship intimacy. Couples called for increasing public awareness of PrEP through positive messaging as a way to combat HIV stigma. Findings suggest that relationship dynamics and broader social contexts appear to shape HIV serodiscordant couples' fertility desires and motivations to use PrEP. However, increased public awareness of PrEP for safer conception may be needed to combat HIV stigma at the community level. SN - 1557-7449 UR - https://www.unboundmedicine.com/medline/citation/28719229/Experiences_Using_Pre_Exposure_Prophylaxis_for_Safer_Conception_Among_HIV_Serodiscordant_Heterosexual_Couples_in_the_United_States_ L2 - https://www.liebertpub.com/doi/full/10.1089/apc.2017.0098?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -