Understanding How Male Partners Influence Women's PrEP Use

How Male Partners Influence Womens PrEP Use Training Presentation A.3

Zethu and Sipho Remember Zethu and Sipho? What did we learn about the role of male partners in positively and negatively influencing women s PrEP use?

Why do woman choose to tell their male partners they are using PrEP? Emotional, logistical, and strategic reasons Promote an open, trusting relationship or prevent a disagreement/breakup Gain partner support in case they later experience side effects or other problems The right thing to do, because their partners would also be exposed to the product Logistics of product use may be difficult to keep secret

Why do women choose not to tell their male partners they are using PrEP? They worry their partner may not be supportive They worry their partner will not feel trusted They worry their partner may start sleeping around They worry their partner may ask or force them to stop using PrEP They worry their partner may be violent They don t feel the need to share the decision with their partner, especially for more casual relationships

How do women decide to tell their male partners they are using PrEP? Is our relationship serious enough to tell him? How will he react? How would he react if he found out later?

Potential male partner roles in womens PrEP use Opposition: Ranging from voicing unease to refusal Concerns about product safety and potential partner infidelity Lack of knowledge about the product Not wanting partners to use something beyond their control Agreement/non-interference: Some gave permission or did not interfere Active support: Demonstrated through: Provision of practical or emotional support to take PrEP Reminding their partners to take PrEP daily Reminding partners of appointments, occasionally accompanying them, or giving them transport money Most men fall in the agreement/non-interference part of the continuum.

Other key points from research in South Africa 1. Some men thought their female partners were using PrEP because they had other sexual partners or did not trust him. 2. Women wanted their male partners to get tested for HIV, use HIV protection, and attend couples counseling. 3. Men were resistant to being HIV tested. They were happy for their female partners to get tested and thought that if their partner was negative, they must also be negative. 4. Men wanted more information about PrEP, and some wanted to speak directly to health care providers, but it was difficult to get men to come to the clinic. 5. Relationships had a lot of conflict (finances, infidelity, social outings/alcohol use). Jealousy was common, lots of mistrust from both partners. 6. Women who were under age 27 or had a new partner in the last three months were more likely to experience negative consequences from using PrEP.

Discussion Questions? Reflections: Was any of the information surprising? What strikes you as some of the most important research findings? 8

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