Creating allies: qualitative exploration of young women’s preferences for PrEP methods and parents’ role in PrEP uptake and user support in urban and rural Zambia
Outcomes: Human Immunodeficiency Virus, Sexual and Reproductive Health
View SourceKey Social Norms Take-aways Social norms surrounding premarital sex significantly limit open communication between adolescent girls and young women (AGYW) and their parents about HIV prevention and pre-exposure prophylaxis (PrEP). These norms hinder AGYW’s ability to disclose PrEP use and prevent parents from engaging meaningfully in sexual and reproductive health (SRH) discussions. However, both AGYW and parents expressed a desire for improved dialogue, suggesting that targeted programs to reshape norms and build communication skills could strengthen parental support for AGYW’s HIV prevention efforts.
Objectives The study aimed to explore AGYW and parents’ perceptions of future PrEP methods and to assess the dynamics of parent-youth engagement in HIV prevention and PrEP use in Zambia.
Methods This qualitative descriptive study was conducted in five provinces across Zambia using 10 focus group discussions (FGDs) and four in-depth interviews (IDIs) with 87 AGYW, and seven FGDs and four IDIs with 62 parents. Data collection occurred in 2021 and employed semi-structured guides, audio recordings, transcription, and a rapid qualitative analysis approach to identify key themes.
Results AGYW preferred injectable PrEP (CAB PrEP) due to its long duration and discreet use, which allows concealment from parents, reflecting fears of stigma linked to assumptions of sexual activity. Many AGYW reported difficulty discussing PrEP with their parents because of cultural taboos, yet expressed a desire for parental support. Parents, while generally uninformed and uncomfortable discussing PrEP due to religious and cultural beliefs, acknowledged the importance of HIV prevention and expressed interest in acquiring the knowledge and skills needed to support their daughters. Both groups favored community sensitization and comprehensive, youth-friendly services.
Conclusions Despite cultural barriers, both AGYW and their parents are willing to engage in discussions on HIV prevention if provided with appropriate support. The study recommends HIV prevention programs expand their focus to include interventions targeting social norms and equip both AGYW and parents with the necessary knowledge and communication skills to foster open, supportive relationships around SRH topics.
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