Barriers to Pre-Exposure Prophylaxis Implementation for HIV-Negative Partners in Serodiscordant Couples in Mwanza, Tanzania: A Short Report

HIV serodiscordant couples are a priority group for prevention in Tanzania. Pre-exposure prophylaxis (PrEP) is an effective intervention for the HIV-negative partner, but its rollout encounters obstacles. Identifying local implementation barriers in regions such as Mwanza is essential. This short report aimed to identify and analyse the principal barriers to PrEP implementation for HIV-negative partners in serodiscordant couples in Mwanza, Tanzania. A qualitative, descriptive study was undertaken. Data were collected through in-depth interviews with healthcare providers in HIV care and focus group discussions with HIV-negative partners from serodiscordant couples who were offered PrEP. Thematic analysis was applied. Three primary thematic barriers were identified: systemic, provider-level, and user-level. A prominent systemic barrier was frequent stock-outs of PrEP medication and testing kits. Key provider-level barriers included insufficient training and low confidence in PrEP counselling. For users, pervasive stigma and fear of being misidentified as living with HIV were major deterrents to uptake and adherence. PrEP implementation for serodiscordant couples in Mwanza is hindered by multi-layered barriers across the health system, providers, and users. These interconnected challenges substantially constrain the intervention’s potential impact. Programmes must strengthen supply chains to ensure consistent PrEP availability. Comprehensive training for healthcare workers on PrEP counselling and stigma reduction is urgently required. Community-led education campaigns are needed to mitigate stigma and normalise PrEP use. HIV prevention, pre-exposure prophylaxis, serodiscordant couples, implementation barriers, Tanzania, qualitative research This report provides local evidence on the multi-level barriers to PrEP implementation, informing the adaptation of service delivery for serodiscordant couples in similar settings.