Male partner involvement in pregnant and breastfeeding women’s use of pre-exposure prophylaxis (PrEP) in a low-income setting in South Africa

Male partner involvement in pregnant and breastfeeding women’s use of pre-exposure prophylaxis (PrEP) in a low-income setting in South Africa | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Male partner involvement in pregnant and breastfeeding women’s use of pre-exposure prophylaxis (PrEP) in a low-income setting in South Africa Kamohelo Mangwane, Sarah Schoetz-Dean, Lucia Knight, Victoria Castillo, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8590800/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract HIV in South Africa remains highly gendered, with women experiencing nearly twice the burden of men. Pregnant and breastfeeding women (PBFW) face elevated HIV acquisition risk, and incident maternal HIV infection during these periods increases the likelihood of vertical HIV transmission. Male partners play a critical role in supporting PBFW to initiate and persist on oral pre-exposure prophylaxis (PrEP), yet limited evidence exists on how best to foster partner support. We conducted in-depth interviews with male partners of PBFW enrolled in a randomized trial (SCOPE-PP) that offered real-time biofeedback counselling on PrEP adherence and access to HIV self-testing (HIVST) in both study arms. Eligible male partners of participants in the intervention arm were invited to participate in November-December 2024. A thematic approach explored men’s perceptions of and support for their partners’ PrEP use. We completed sixteen interviews. Median relationship length was six years; four partners were married to the index participant. All PBFW were taking PrEP at the time of the interview. Men generally held positive views of PrEP, describing it as protective for both mother and infant. Many provided emotional encouragement or practical support. Open communication helped resolve initial mistrust or gendered assumptions that women’s PrEP use signaled suspicion of male infidelity. Exposure to PrEP also prompted men to reflect on their own HIV prevention needs. Findings underscore the value of approaches that center communication within couples to strengthen disclosure and male engagement in PrEP uptake and adherence during the perinatal period and to promote shared responsibility for HIV prevention within families. Pre-exposure prophylaxis (PrEP) male engagement pregnancy postpartum women HIV prevention South Africa qualitative research Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 31 Mar, 2026 Reviewers agreed at journal 30 Mar, 2026 Reviews received at journal 10 Mar, 2026 Reviewers agreed at journal 29 Jan, 2026 Reviewers agreed at journal 28 Jan, 2026 Reviewers invited by journal 23 Jan, 2026 Editor assigned by journal 15 Jan, 2026 Submission checks completed at journal 15 Jan, 2026 First submitted to journal 13 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8590800","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":581059814,"identity":"a18ba0a8-ed9e-4feb-b4df-4e8aaa4e44bf","order_by":0,"name":"Kamohelo Mangwane","email":"","orcid":"","institution":"University of Cape Town","correspondingAuthor":false,"prefix":"","firstName":"Kamohelo","middleName":"","lastName":"Mangwane","suffix":""},{"id":581059815,"identity":"ff4f1e00-c915-4238-9008-1af385dcdb46","order_by":1,"name":"Sarah Schoetz-Dean","email":"","orcid":"","institution":"University of California Los 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Pregnant and breastfeeding women (PBFW) face elevated HIV acquisition risk, and incident maternal HIV infection during these periods increases the likelihood of vertical HIV transmission. Male partners play a critical role in supporting PBFW to initiate and persist on oral pre-exposure prophylaxis (PrEP), yet limited evidence exists on how best to foster partner support.\u003c/p\u003e \u003cp\u003eWe conducted in-depth interviews with male partners of PBFW enrolled in a randomized trial (SCOPE-PP) that offered real-time biofeedback counselling on PrEP adherence and access to HIV self-testing (HIVST) in both study arms. Eligible male partners of participants in the intervention arm were invited to participate in November-December 2024. A thematic approach explored men\u0026rsquo;s perceptions of and support for their partners\u0026rsquo; PrEP use.\u003c/p\u003e \u003cp\u003eWe completed sixteen interviews. 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