Barriers to the Adoption of Pre-Exposure Prophylaxis among Serodiscordant Couples in South Kivu

Abstract

Introduction : Pre-exposure prophylaxis (PrEP) has been introduced in the Democratic Republic of the Congo since 2016 as an innovative prevention strategy against HIV transmission, targeting serodiscordant couples in particular. This study aimed to explore the practices of serodiscordant couples to reduce the risk of HIV contamination, their level of knowledge about PrEP, its use and the obstacles encountered in South Kivu province. Materials and Methods : This qualitative study was conducted in October 2022 at the Centre de Santé Muhungu Diocésain, in the commune of Ibanda in Bukavu, South Kivu province. Sixteen serodiscordant couples were purposively selected to participate in individual semi-directive interviews, guided by a structured tool. An inductive thematic analysis of the transcripts identified the main themes. Results : Serodiscordant couples had little or no knowledge of PrEP, which explains its almost non-existent use. The majority of participants reported using condoms as a means of prevention, but this practice was often abandoned after around four months, regardless of the viral load status of the HIV-positive partners. The lack of information available on PrEP and the disorientation of some couples by healthcare providers are among the main barriers to its use. Conclusion : For a better uptake of PrEP, it is essential to train and inform all healthcare providers on this approach so that they can effectively sensitize serodiscordant couples to HIV.