Salient beliefs and intention to use pre-exposure prophylaxis among pregnant and breastfeeding women in Zambia: Application of the Theory of Planned Behaviour

Hamoonga, Twaambo Euphemia; Mutale, Wilbroad; Hill, Lauren; Igumbor, Jude; Benjamin, H.

doi:10.1080/17441692.2023.2184483

Cited by 6 publications

(9 citation statements)

References 46 publications

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“…Similar to our findings, a study conducted in Botswana, Tanzania and Uganda reported that lost wages due to waiting time was a barrier to adherence among individuals on antiretroviral therapy ( 52 ). These findings are corroborated by those from a recent study conducted by our team ( 36 ).…”

Section: Discussionsupporting

confidence: 90%

“…The second part which took the form of an interview guide was developed based on the Theory of Planned Behaviour questionnaire ( 27 ). The Theory of Planned Behaviour questionnaire has been used in several studies focusing on health-related behaviour to predict both intention and actual behaviour ( 31 – 36 ). The interview guide focused on behavioural beliefs (beliefs about advantages and disadvantages of taking PrEP), normative beliefs (beliefs about how other people expect pregnant and breastfeeding women to behave with respect to whether or not to take PrEP), and control beliefs (how much control pregnant and breastfeeding women have over taking PrEP) ( 28 ).…”

Section: Methodsmentioning

confidence: 99%

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“PrEP protects us”: Behavioural, normative, and control beliefs influencing pre-exposure prophylaxis uptake among pregnant and breastfeeding women in Zambia

Hamoonga

Mutale

Hill

et al. 2023

Front. Reprod. Health

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BackgroundAlthough pre-exposure prophylaxis (PrEP) is recommended for pregnant and breastfeeding women at elevated HIV risk, uptake has been low in Zambia.MethodsIn in-depth interviews, we explored beliefs about PrEP among 24 HIV-negative pregnant and breastfeeding Zambian women. Thematic analysis was used to identify behavioural, normative and control beliefs likely to influence PrEP uptake.ResultsMost women viewed PrEP as a good method of protecting themselves and their babies from HIV infection. Partners were cited as key referents in decision making about PrEP use. Many women felt that PrEP use was not entirely in their control. Most reported that they would not use PrEP if their partners did not approve. Health care providers with negative attitudes, long distance to clinics, and extended waiting times were cited as barriers to PrEP uptake.ConclusionHIV-negative pregnant and breastfeeding women had a positive attitude towards PrEP but barriers to uptake are multifaceted.

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

“PrEP protects us”: Behavioural, normative, and control beliefs influencing pre-exposure prophylaxis uptake among pregnant and breastfeeding women in Zambia

Hamoonga

Mutale

Hill

et al. 2023

Front. Reprod. Health

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“…The odds of intention to use PrEP were high among women with low levels of education, awareness of PrEP, high self-efficacy and high willingness to use PrEP. These findings are similar to other studies where women with awareness of PrEP and high self-efficacy showed increased willingness to use PrEP ( 28 , 55 ). On the contrary, Scott et al in a research among PPW found that self-efficacy was not associated with PrEP uptake intention ( 56 ).…”

Section: Discussionsupporting

confidence: 91%

“…Extending PrEP promotion to the community can help to reach populations who do not regularly attend health facilities ( 34 ). Other studies have reported similar findings where health facilities and healthcare workers are the most cited sources of PrEP information ( 12 , 28 , 30 , 31 , 34 ). In this regard, HCWs play a critical role in delivering PrEP in antenatal and postpartum care to PPW.…”

Section: Discussionsupporting

confidence: 66%

“…In South Africa, in a study among pregnant women from Cape Town knowledge about PrEP was only 33% ( 12 ) and in a study among young pregnant women aged 18–24 years old in KwaZulu Natal, none of the women had ever heard about PrEP before the survey ( 32 ). In Zambia, knowledge about PrEP among pregnant and breastfeeding was only 36% ( 28 ). In the United States approximately two thirds of pregnant women had never heard of PrEP before participating in the study ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

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Uptake of and intention to use oral pre-exposure prophylaxis for HIV among pregnant and post-natal women in Eswatini: a cross-sectional survey

Khumalo,

Mkhonta,

Kindandi

et al. 2023

Front. Reprod. Health

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IntroductionIn Eswatini, HIV incidence among women of childbearing age is 1.45%. Eswatini introduced oral pre-exposure prophylaxis (PrEP) for HIV prevention in 2016 and requires that all HIV-negative pregnant and post-natal women (PPW) visiting health care facilities be offered PrEP.MethodsBetween September-November 2021, we conducted a survey among HIV-negative PPW from 16 purposively selected healthcare facilities in the Hhohho and Shiselweni regions in Eswatini. We interviewed consenting HIV-negative PPW using a structured questionnaire to collect data on PrEP knowledge, attitudes, intentions, and practices, as well as information on partner HIV status and stigma. Multivariate logistic regression was used to determine predictors of PrEP use and intention, adjusted for significant covariates.ResultsOf 1,484 PPW women approached, 1,149 consented and were interviewed, of whom 704 (61.3%) were post-partum and 445 (38.7%) pregnant. The median age was 25 years [Interquartile Range (IQR) = 21–30 years], with 533 (46.4%) 18–24 years old. Among the 1,149 women, 930 (80.7%) had ever heard about PrEP; 635 (55.3%) had knowledge about PrEP; 183 (15.9%) were currently using PrEP; and 285 (24.8%) had ever used PrEP. Increased odds of PrEP use were associated having HIV-positive male partner (aOR:7.76, 95%CI 3.53- 17.04); positive attitudes to PrEP (aOR:1.56, 95%CI: 1.02–2.40); and high self-efficacy (aOR:1.49, 95%CI:1.13–1.98). Among 864 women who never used PrEP, 569 (65.3%) intended to use PrEP in the future. Odds of intention to use PrEP were higher among women with low levels of education (aOR:2.23, 95% CI: 1.32–3.77); who ever heard about PrEP (aOR:1.69, 95%CI: 1.12–2.56); and had high self-efficacy (aOR:1.57, 95%CI: 1.31–1.87). Regarding stigma, among all women, 759 (66%) either agreed or strongly agreed that people would think they have HIV if they were to use PrEP; 658 (57.3%) reported they would be labelled as having multiple sex partners; 468 (40.7%) reported that their partner would think they are having risky sex with other people. Of 102 women who had discontinued PrEP, a majority stopped due to side effects 32 (35.2%).ConclusionOnly about 50% of women had knowledge of PrEP, and PrEP uptake among PPW was low, though intention to use appeared high. More efforts to reduce stigma and promote PrEP use, including adequate information on side effects, are needed.

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Theory of planned behavior in creating disease prevention behavior

Prasetya,

Darmayanti,

Setyorini

2024

IJPHS

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Human behavior, in dealing with pandemic, becomes one of the key factors during the speed of an outbreak. In this way, individual and social responsibility are needed to determine behaviors, end the pandemic, and anticipate for the next outbreak. The purpose of this systematic review is to provide structured information about the results of applying the theory of planned behavior (TPB) in concern to create COVID-19 preventive behavior (CPB) as the case example. This systematic review was compiled by searching articles using the keywords "theory of planned behavior"[MeSH] AND COVID-19 preventive behavior. ("theory of planned behavior"[MeSH]) AND "hand disinfection"[MeSH]. "Theory of planned behavior" AND "social distancing." "Theory of planned behavior" AND "wearing mask." The search was obtained from PUBMED and Google Scholar. The 13 articles met the requirements to be reviewed qualitatively on the implementation of TPB. The results showed that TPB was effective to bring about the prevention behavior of infectious disease, such as COVID-19. Other significant aspects are intentions, norms, and behavioral control. The TPB model can be applied for health promotion in creating prevention behavior of infectious disease.

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Salient beliefs and intention to use pre-exposure prophylaxis among pregnant and breastfeeding women in Zambia: Application of the Theory of Planned Behaviour

Cited by 6 publications

References 46 publications

“PrEP protects us”: Behavioural, normative, and control beliefs influencing pre-exposure prophylaxis uptake among pregnant and breastfeeding women in Zambia

“PrEP protects us”: Behavioural, normative, and control beliefs influencing pre-exposure prophylaxis uptake among pregnant and breastfeeding women in Zambia

Uptake of and intention to use oral pre-exposure prophylaxis for HIV among pregnant and post-natal women in Eswatini: a cross-sectional survey

Theory of planned behavior in creating disease prevention behavior

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