"He would not only be my partner in the relationship but also a partner in the research": the role of male partners in women's PrEP research.

In sub-Saharan Africa, HIV risk increases during pregnancy and the postpartum periods. Biomedical HIV prevention, such as pre-exposure prophylaxis (PrEP), has demonstrated safety and efficacy; however, uptake and continuation rates are low. Male partners are an important influence on women's PrEP use, yet little is known about how to engage partners effectively in PrEP research. Between July and November 2024, 20 qualitative in-depth interviews were conducted with pregnant and postpartum women and their male partners (10 couples) in a clinic in Gaborone, Botswana. Interviews explored PrEP decision-making, perceived risks and benefits, and preferences for partner involvement in PrEP research. Overall, the decision for women to participate in PrEP research was shaped by a couple-focused approach emphasizing partnership. Concern for the baby's health encouraged shared decision-making but sometimes justified women making the final call. Male partner participation in women's PrEP research was seen as beneficial, through increasing support for women and providing an opportunity to link men with health services. Our findings suggest that male involvement in women's PrEP research and services could benefit both partners. Future research should seek to increase men's engagement in women's health while placing importance on safeguarding women's autonomy.