Pre-exposure prophylaxis low uptake associated factors among pregnant women attending Antenatal care at Intermediate Hospital Katutura
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Date
2025
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University of Namibia
Abstract
This study explored the factors influencing the use of Pre-Exposure Prophylaxis (PrEP)
among pregnant women attending antenatal care at Intermediate Hospital Katutura. Using
a mixed-methods approach, the research combined quantitative surveys and qualitative
interviews to evaluate both the determinants of PrEP uptake and the participants’
understanding and acceptance of PrEP. The study was conducted on 150 participants using
systematic random sampling for the quantitative data and 14 participants using purposive
sampling for qualitative data. Data was used using structured questionnaires for
quantitative data and in-depth interview for qualitative data. SPSS version 28.0 was used
to analyse the quantitative data and thematic analysis was used to analyse the qualitative
data.
Quantitative analysis of 150 pregnant women identified significant associations between
PrEP use and socio-demographic factors. Notably, employment status was a key predictor,
with women in blue-collar jobs and those unemployed demonstrating significantly lower
odds (ORs of 0.55 and 0.65; p=0.006) of PrEP uptake. Although higher age, gravidity,
and parity showed trends toward lower uptake, these were not statistically significant at
the 0.05 level. Additionally, women in their second trimester were significantly more
likely (p=0.045) to adopt PrEP compared to those in their first trimester, emphasizing the
influence of pregnancy stage on health behavior. Concerns about potential side effects are
a major barrier, influencing the decision of 50% of the participants not to take PrEP, with
only 25% disagreeing with this sentiment
Qualitative findings highlighted social and cultural beliefs, perceived support from
healthcare providers and partners, and barriers such as stigma, misinformation, and
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potential side effects impacting PrEP acceptance. The qualitative study used two themes:
the perception of the pregnant women on the awareness of PrEP among pregnant women
attending ANC at IHK and the perception of pregnant women on the acceptability of PrEP
among pregnant women attending ANC at IHK Based on these results, the study
recommends targeted awareness campaigns, enhanced healthcare provider training,
support programs involving family and partners, and efforts to address financial and rural–
urban disparities. Reducing stigma and misinformation, alongside ongoing program
monitoring, are essential to bolster PrEP uptake and improve HIV prevention among
pregnant women
Description
A theses submitted in Partial fulfilment of the requirements for the degree of Master in Public Health