When women’s HIV prevention becomes unstable: findings from a longitudinal qualitative study in Sierra Leone

participation, service contact and social support. Analysis of male participants' accounts identified three male partner orientations in relation to women's HIV prevention: protective complicity, dismissive gatekeeping, and fearful avoidance. Structural instability emerged as a useful analytic lens for understanding changing enabling conditions. Prevention programmes may need to protect women's privacy, reduce economic and relationship barriers and keep services accessible, rather than assume one-time behaviour change will last.