Knowledge and preferences for safer conception methods among sero-different fisherfolk couples in Kisumu, Kenya: a qualitative analysis.

Safer conception (SC) methods to reduce HIV transmission to sero-different partners during conception are available; however, little is known about which methods are acceptable and preferred. We examined SC knowledge and preferences to inform development of a couples' SC intervention. In-depth interviews with HIV sero-different couples desiring children (n = 16 couples, 32 individuals) were conducted in Lake Victoria communities in Kisumu County, Kenya (November 2023-February 2024). Interviews examined knowledge and preferences regarding five locally available SC methods. Investigators developed a codebook through an iterative process, coded, and analyzed data using framework analysis to allow for dyadic comparisons. Among 32 participants, awareness of SC methods was limited, and most reported providers had not discussed SC with them. After learning about available methods, most preferred PrEP, ART, or a combination because of their perceived safety, accessibility, and effectiveness in preventing HIV transmission. Vaginal insemination was the least preferred method because it was viewed as complicated and unnatural. Most participants favored combining SC methods to maximize protection when trying to conceive. Tailoring counseling to educate couples about options and offering a range of SC methods may help couples utilize SC methods that are effective and best suited to their personal relationship circumstances and needs.