Young women’s lived experiences of using PrEP in Namibia: A qualitative phenomenological study

Background: Young women are more likely to acquire Human Immunodeficiency Virus (HIV) than other population groups. Pre-exposure prophylaxis (PrEP) is using antiretroviral medicines by HIV-negative individuals before HIV exposure to avert HIV infection. Various conditions may influence women’s decisions to initiate and continue PrEP. Objective: This study aimed to explore young women’s lived experiences using PrEP in the Rundu district, Namibia. Method: Face-to-face in-depth interviews were conducted with nine young women between 21 and 24 years who had experience of current or previous use of PrEP and attended at least one follow-up visit after commencing PrEP. Colaizzi’s seven-step process of qualitative data analysis was used to analyse data. Findings: Young women were aware of their risk of acquiring HIV, prompting them to use PrEP. These risks included a lack of awareness of their partner’s HIV status, 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 by enabling them to make choices about managing their risk. Some women persisted using PrEP despite several challenges, including the lack of privacy, stigma and inadequate support. Conclusion: 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

Healthcare provider perceptions of safety culture: A multi-site study using the safety attitudes questionnaire

Introduction: Patient safety culture, the way in which members of a healthcare organisation think about and prioritise safety, has been linked to positive patient outcomes. The aim of this study was to use the Safety Attitudes Questionnaire (SAQ) to measure the safety culture in a variety of healthcare settings located in the province of Munster of Ireland. Methods: The SAQ was applied in six healthcare settings in the Munster province of Ireland between December 2017 and November 2019. The attitudes of healthcare staff towards six domains of safety culture were assessed over 32 Likert-scaled items. The mean, median, interquartile range and percent positive scores for each domain were calculated for the study population, and subgroup analyses were carried out between study sites and professions. Results for each setting were compared to international benchmarking data. Chi-Squared tests were used to determine whether study site or profession were related to domain scores. Reliability analysis was carried out using Cronbach's alpha. Results: Study participants (n = 1749) comprising doctors, pharmacists, nurses, and healthcare assistants, were found to have positive attitudes towards patient safety culture but scored poorly in the domains Working Conditions and Perceptions of Management. Perceptions of safety culture were more positive in smaller healthcare settings, and amongst nurses and HCAs. The survey had acceptable internal consistency. Conclusions: In this study investigating the safety culture of healthcare organisations in Ireland, study participants had generally positive attitudes towards the safety culture in their organisation, however working conditions, perceptions of management, and medication incident reporting were identified as key areas for improvement