{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T02:23:03Z","timestamp":1790043783473,"version":"4.0.1"},"reference-count":47,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,6,10]],"date-time":"2020-06-10T00:00:00Z","timestamp":1591747200000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["UM1AI068633"],"award-info":[{"award-number":["UM1AI068633"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["UM1AI068615"],"award-info":[{"award-number":["UM1AI068615"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["UM1AI106707"],"award-info":[{"award-number":["UM1AI106707"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Women in sub\u2010Saharan Africa spend a substantial portion of their reproductive lives pregnant and\/or breastfeeding (P\/BF), yet they have limited options to prevent HIV during these maternal stages. In preparation for phase 3b prevention trials in P\/BF women, we explored attitudes about using a vaginal ring or oral pills for pre\u2010exposure prophylaxis (PrEP), perceptions of HIV risk during P\/BF and key influences on future PrEP use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In 2018, we conducted 16 single\u2010sex focus group discussions (FGDs) with community\u2010 and clinic\u2010recruited HIV\u2010uninfected women, currently or recently P\/BF, aged 18 to 40, and men with (currently or recently) P\/BF partners, aged 18+. Participants completed a behavioural questionnaire, viewed an educational video and handled prototype placebo products. FGDs were conducted in local languages and transcribed, coded and analysed, using a socio\u2010ecological framework, for key influences on willingness to use products, HIV risk perceptions and opinions on product attributes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 128 participants (65 women, 63 men) 75% lived with their partner and 84% had a child. Women reported the most important influencers when P\/BF were partners, and all stated that health decisions when P\/BF are typically made jointly (e.g. medication use; ante\/postnatal and baby care). There was consensus that P\/BF women are at high risk for HIV, primarily because of their partner\u2019s infidelities, and new prevention options were welcomed. Participants valued multiple options and stated that woman\u2019s personal preference would be key to product choice. Anticipated concerns about products included risk of miscarriage, impact on infant development, complications during delivery and adequate production or taste of breastmilk. Specific perceived disadvantages emerged for the ring (e.g. vaginal discomfort, difficulty inserting\/removing) and for pills (e.g. nausea\/vomiting) that may be exacerbated during pregnancy. Health care providers\u2019 (HCPs) knowledge and approval of product use during P\/BF was needed to mitigate anticipated fears.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Participants perceived pregnancy and breastfeeding as high HIV risk periods and valued new prevention options. HIV protection of the mother\u2010child dyad, safety of the baby, and ultimately, health of the family were paramount. Endorsement by HCPs and support from partners were key to future product acceptance. Participants recommended involving partners and HCPs in sensitization efforts for future trials.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25536","type":"journal-article","created":{"date-parts":[[2020,6,11]],"date-time":"2020-06-11T06:59:02Z","timestamp":1591858742000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Influences on willingness to use vaginal or oral HIV PrEP during pregnancy and breastfeeding in Africa: the multisite MAMMA study"],"prefix":"10.1002","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8536-648X","authenticated-orcid":false,"given":"Ariane","family":"van der Straten","sequence":"first","affiliation":[{"name":"Women\u2019s Global Health Imperative (WGHI) RTI International Berkeley CA USA"},{"name":"Center for AIDS Prevention Studies (CAPS) University of California San Francisco San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia H","family":"Ryan","sequence":"additional","affiliation":[{"name":"Women\u2019s Global Health Imperative (WGHI) RTI International Berkeley CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishnaveni","family":"Reddy","sequence":"additional","affiliation":[{"name":"Wits Reproductive Health and HIV Institute (Wits RHI) University of the Witwatersrand Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliane","family":"Etima","sequence":"additional","affiliation":[{"name":"Makerere University \u2013 Johns Hopkins University Research Collaboration Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Taulo","sequence":"additional","affiliation":[{"name":"Johns Hopkins Project\u2010College of Medicine University of Malawi Blantyre Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prisca","family":"Mutero","sequence":"additional","affiliation":[{"name":"University of Zimbabwe College of Health Sciences Clinical Trials Research Centre Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamilah","family":"Taylor","sequence":"additional","affiliation":[{"name":"FHI 360 Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanna","family":"Piper","sequence":"additional","affiliation":[{"name":"DAIDS NIH\/NIAID Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petina","family":"Musara","sequence":"additional","affiliation":[{"name":"University of Zimbabwe College of Health Sciences Clinical Trials Research Centre Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the MTN\u2010041\/MAMMA Study Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,10]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Stakeholders Consultation on MTN\u2010042: Phase 3B open\u2010label safety study of the dapivirine vaginal ring and oral PrEP used during pregnancy","author":"Microbicide Trials Network","year":"2018"},{"key":"e_1_2_9_3_1","unstructured":"Organization WH.World Life Expectancy.2017[cited 2019 Oct 29]. 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