Ask AI
Back Back
Female Controlled PrEP
Female-Controlled PrEP: Empowering Women and Minimizing the Impact of Partner Resistance

Released: April 10, 2026

Elizabeth Anne Bukusi
Elizabeth Anne Bukusi, MBChB, MMed (ObGyn), MPH, PhD, PGD (Research Ethics), MBE (Research Ethics)
Activity Information

Activity

Progress
1
Course Completed
Continue
Key Takeaways
  • Many women in sub-Saharan Africa rely on their partners for access to healthcare, so partner resistance can be a significant barrier to accessing PrEP.
  • Female-controlled PrEP is empowering and critical to ending the HIV epidemic.

It is critical to prioritize female-controlled HIV prevention strategies in sub-Saharan Africa because, sadly, the face of HIV in sub-Saharan Africa remains young and female. When it comes to new incident HIV infections in this region, women between 16 and 24 years of age are the most likely to get infected.

Partner Resistance as a Barrier to HIV Prevention
Partner resistance and lack of partner support greatly affect women’s ability to protect themselves from HIV. The reality is that sub-Saharan Africa remains a place with many patriarchal practices and social norms. Even though many women are socially and economically empowered, many women do not have social and financial freedom.

Many women are still dependent on male partners for access to healthcare. For example, if a woman is not working, she is dependent on her male partner for healthcare. If she needs assistance from him to make an appointment, he may want to know what it is for. Lack of support in that regard makes it much more difficult to engage in healthcare, particularly for HIV prevention. That is why there is a critical need for female-controlled prevention strategies to empower women and minimize the impact of partner resistance.

Persistent Stigma Surrounding HIV Prevention
In addition to barriers from partner resistance, cultural norms in sub-Saharan Africa can also pose a challenge. If a woman expresses a desire to protect herself from HIV or admits to having HIV, she is likely to be labeled as unfaithful, promiscuous, or immoral. However, the expectation is that women are responsible for protecting themselves from HIV, even if their risk is from their partner rather than their own sexual activity.

Unfortunately, stigma is also pervasive among healthcare professionals (HCPs), who often have attitudes that can reinforce stigma. Assumptions about promiscuity, sex work, or infidelity, whether explicit or implied, can create an unwelcoming environment and make women feel guilty for seeking care. Therefore, HCPs must be educated so they can have an active role in normalizing pre-exposure prophylaxis (PrEP), including destigmatizing HIV testing, treatment, and prevention.

The Impact of Female-Controlled PrEP Strategies
Female-controlled HIV prevention strategies are very empowering. I recall the story of one woman, who said, “I cannot control my partner or follow him everywhere. I cannot determine what he does. But now that I am in control of my PrEP, that gives me some peace of mind that I am not at risk. Regardless of what choices he makes, I have the opportunity to make good choices for myself and not become infected.” There are many stories like hers, stories of women able to live life and have relationships without fear because of PrEP.

What Does Female-Controlled PrEP Delivery Look Like?
I think differentiated delivery models are an excellent way to give women more control over PrEP, especially in places with limited resources. Bringing PrEP services closer to the people makes a significant difference in uptake and adherence, whether it is a portable clinic, a community-based service, or simply someone on a motorbike.

Integrating PrEP with other healthcare services is also critical for giving women more control over their choices. I believe sexual healthcare, prenatal care, and HIV care should be centralized to make them all more accessible. Ideally, all these services should be located with primary care as a “one-stop shop” so women can receive comprehensive care for themselves and their families without needing to access multiple, disconnected systems.

Your Thoughts
How do you empower your female patients to take charge of HIV prevention? Leave a comment to join the discussion!

Continue