Browsing by Author "Vasco, Ester Kandambo"

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    The lived experiences of young women on the use of HIV pre-exposure prophylaxis in Namibia
    (Stellenbosch : Stellenbosch University, 2021-12) Vasco, Ester Kandambo; Crowley, Talitha; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY : Background: Young women have a higher risk of acquiring HIV than other population groups. In sub-Saharan African, at least five in six new HIV infections happen in girls between the ages of 15-19 years. This age group is particularly at a high risk of acquiring HIV due to issues affecting young women such as gender based violence, sexual abuse, limited access to education and health services, and inequalities and injustice. Pre-exposure prophylaxis (PrEP) is the use of antiretroviral medicines by HIV negative individuals before HIV exposure to avert HIV infection. However, since its introduction in Namibia, in 2016, PrEP uptake amongst young women remains low. Various conditions may influence women‟s decisions to initiate and continue PrEP. Little is known about the lived experiences of young women on the use of PrEP. Aim and objectives: The aim of the study was to explore the lived experiences of young women on the use of PrEP in Namibia. The objectives were to: - explore the knowledge and understanding of young women about PrEP, - describe the socio-cultural, educational and informational conditions that influenced their decision to use PrEP, - describe the physical, emotional and social support needs of young women using PrEP. Methods: A qualitative descriptive phenomenological design was used. The study inclusion criteria were: young women aged between 21 and 24 years; current or previous use of PrEP; and attendance of at least one follow-up visit after commencing PrEP. The sample included nine participants from five clinics in and around the town of Rundu, in the Rundu district of the Kavango East region of Namibia. A purposive sampling method was used to obtain maximum variability. Data collection involved face-to-face in-depth interviews using a semi-structured interview guide. Colaizzi’s seven-step process was used to analyse data. Ethics approval was obtained from the Stellenbosch University Health Research Ethics Committee reference number, S19/02/031. Furthermore permission was obtained from the Ministry of Health and Social Services and the regional health director of Kavango East region. Findings: Three themes were identified: risk awareness, empowered for self-care, and persisting despite the challenges. Young women in this study were aware of their risk of acquiring HIV and this prompted them to use PrEP. These risks included lack of awareness of their partne’s HIV status coupled with a lack of trust in their partners; or being in a sexual relationship with a partner living with HIV. Awareness also emanated from information provided by healthcare workers, peers and the media. Using PrEP empowered young women for self-care through enabling them to make choices about managing their risk. Some of the women persisted using PrEP despite several challenges which included the lack of privacy, stigma and inadequate support. Conclusion and recommendations: PrEP is an empowering HIV prevention strategy for young women, however, much still needs to be done to promote young women‟s willingness to initiate and continue PrEP. PrEP awareness campaigns should be expanded to address myths and misconceptions and positively influence social norms. Differentiated PrEP delivery models should be implemented, including integration with other services such as sexual reproductive health services, effective counselling and peer support.