About

Lisa D. Pearce is a professor involved in research that takes a population perspective, focusing on religious and family dynamics within the general population. She employs demographic methods, such as event history models, and analyzes representative survey data in her projects. Trained as a demographer, she is a member of the Population Association of America, attends their annual meetings, and publishes in demographic journals. Her work emphasizes population science training, and she is interested in mentoring students whose interests overlap with her research areas, particularly those interested in demographic approaches and population studies.

Research topics

• Sociology
• Demography
• Political Science
• Psychology
• Social psychology
• Developmental psychology
• History
• Genealogy
• Gender studies
• Environmental health
• Medicine

Selected publications

• Understanding PrEP misconceptions and their impact on PrEP initiation and use among pregnant and lactating women in Malawi

  PLOS Global Public Health · 2025-05-27 · 3 citations

  articleOpen accessCorresponding

  Mother-to-child transmission (MTCT) of HIV remains a challenge in Eastern and Southern Africa. Oral pre-exposure prophylaxis (PrEP) is a powerful tool to reduce MTCT, but women face barriers to effective use including those related to inaccurate comprehension of PrEP To understand women's misconceptions about PrEP and their potential impact on PrEP use, we conducted interviews with 33 pregnant and lactating women in Malawi using PrEP, and ten PrEP counselors and clinicians. The results indicate that, although pregnant women generally understood PrEP's features and functions, many held misconceptions that persisted over the course of their PrEP use and impacted their perceptions and use of the medication. Some women erroneously believed that PrEP could treat and prevent sexually transmitted infections other than HIV, which motivated some to keep taking PrEP while motivating others to stop using PrEP once their STI had resolved. Some were confused about PrEP's function, with some believing it was the same as antiretroviral therapy for HIV treatment, and others believing that PrEP could be used for overall enhancement of health. Rarer misconceptions included fears that PrEP was connected to satanic practices, could cause cancer, or was solely for individuals engaged in sex work. These misconceptions stemmed from a mix of prior knowledge, societal influences, and miscommunications during counseling sessions. Ensuring accurate knowledge and addressing common misconceptions head-on is crucial to promote continued PrEP use among women. Both clinic- and community-based communication efforts with a particular focus on the difference between PrEP, STI treatments, and ART are needed.

  PublisherDOI

• The Gendered Relationship between Parental Religiousness and Children’s Marriage Timing

  UNC Libraries · 2025-07-16

  articleOpen accessSenior author

  In this article, we examine whether mother's and father's self-reported religiousness relates differently to the timing of their children's marriages. Conceptualizing religion as one source of cultural schema about marriage that is likely to conflict with other schemas for living, and theorizing that women are more likely to experience structured ambivalence over religious schema and their enactment than men, we predict father's religiousness will be associated with children's marriage in accordance with religious dogma, whereas the experience of structured ambivalence yields a more complex relationship between mother's religiousness and their children's marriage. Using longitudinal data from the Chitwan Valley Family Study in Nepal, a primarily Hindu and Buddhist setting, we find contrasting associations between son's marriage timing and mothers' and fathers' religiousness. This provides empirical support for theoretical frameworks that emphasize the gendered nature of religious identity and suggests the influence of religion on other aspects of life is gendered.

  PublisherDOI

• Supporting Oral and Long-Acting HIV Preexposure Prophylaxis Decision-Making Among Pregnant Women (MyChoice Intervention): Protocol for 2 Pilot Randomized Controlled Trials (Preprint)

  2025-04-24

  preprintOpen access

  <sec> <title>BACKGROUND</title> HIV preexposure prophylaxis (PrEP) has potential for preventing HIV during the perinatal period, but few strategies promote person-centered shared decision-making (SDM) about PrEP use in these contexts. The MyChoice study aims to evaluate the feasibility, acceptability, and appropriateness of an SDM approach to support pregnant and breastfeeding women in Lilongwe, Malawi, integrating PrEP into antenatal care to encourage consistent use. </sec> <sec> <title>OBJECTIVE</title> Two pilot studies will assess the feasibility, acceptability, and appropriateness of an SDM intervention to support pregnant and breastfeeding women in making informed HIV prevention choices. The intervention will also explore the perspectives of participants, their male partners, and implementers. Each study compares the MyChoice intervention to standard-of-care PrEP counseling, with different HIV prevention method choices available. </sec> <sec> <title>METHODS</title> We will conduct 2 pilot randomized trials to evaluate the MyChoice intervention, designed to support PrEP decision-making among pregnant women in Lilongwe. Both studies will compare the MyChoice intervention to standard-of-care PrEP counseling. Study 1 will include 100 participants who will be offered oral PrEP and condoms for 3 months. Study 2 will include 50 participants who will be offered oral PrEP or injectable long-acting cabotegravir and condoms for 2 months. The primary end points for MyChoice study 1 are intervention acceptability, intervention appropriateness, and intervention feasibility, whereas for MyChoice study 2 they are intervention acceptability and intervention appropriateness. The secondary end point for MyChoice study 1 is decisional conflict, and for MyChoice study 2, it is the feasibility of study procedures. Exploratory end points include PrEP uptake assessment and dried blood spot measurement of PrEP adherence for MyChoice study 1 and PrEP uptake assessment for MyChoice study 2. </sec> <sec> <title>RESULTS</title> Data collection started on July 30, 2024, for study 1 and on February 10, 2025, for study 2. A total of 100 participants were enrolled in MyChoice study 1, and 50 participants were enrolled in MyChoice study 2. Study follow-up has been completed. Data analysis is expected to be completed by November 2025. </sec> <sec> <title>CONCLUSIONS</title> The MyChoice pilot studies will provide critical evidence on a novel intervention for PrEP decision-making during pregnancy and breastfeeding. If feasible and acceptable, these results will form the basis for larger efficacy trials to promote PrEP uptake during pregnancy. </sec> <sec> <title>CLINICALTRIAL</title> ClinicalTrials.gov NCT06394323; https://clinicaltrials.gov/study/NCT06394323 and ClinicalTrials.gov NCT06397690; https://www.clinicaltrials.gov/study/NCT06397690 </sec> <sec> <title>INTERNATIONAL REGISTERED REPORT</title> DERR1-10.2196/76442 </sec>

  PublisherDOI

• Supporting Oral and Long-Acting HIV Preexposure Prophylaxis Decision-Making Among Pregnant Women (MyChoice Intervention): Protocol for 2 Pilot Randomized Controlled Trials

  JMIR Research Protocols · 2025-09-26

  articleOpen access

  BACKGROUND: HIV preexposure prophylaxis (PrEP) has potential for preventing HIV during the perinatal period, but few strategies promote person-centered shared decision-making (SDM) about PrEP use in these contexts. The MyChoice study aims to evaluate the feasibility, acceptability, and appropriateness of an SDM approach to support pregnant and breastfeeding women in Lilongwe, Malawi, integrating PrEP into antenatal care to encourage consistent use. OBJECTIVE: Two pilot studies will assess the feasibility, acceptability, and appropriateness of an SDM intervention to support pregnant and breastfeeding women in making informed HIV prevention choices. The intervention will also explore the perspectives of participants, their male partners, and implementers. Each study compares the MyChoice intervention to standard-of-care PrEP counseling, with different HIV prevention method choices available. METHODS: We will conduct 2 pilot randomized trials to evaluate the MyChoice intervention, designed to support PrEP decision-making among pregnant women in Lilongwe. Both studies will compare the MyChoice intervention to standard-of-care PrEP counseling. Study 1 will include 100 participants who will be offered oral PrEP and condoms for 3 months. Study 2 will include 50 participants who will be offered oral PrEP or injectable long-acting cabotegravir and condoms for 2 months. The primary end points for MyChoice study 1 are intervention acceptability, intervention appropriateness, and intervention feasibility, whereas for MyChoice study 2 they are intervention acceptability and intervention appropriateness. The secondary end point for MyChoice study 1 is decisional conflict, and for MyChoice study 2, it is the feasibility of study procedures. Exploratory end points include PrEP uptake assessment and dried blood spot measurement of PrEP adherence for MyChoice study 1 and PrEP uptake assessment for MyChoice study 2. RESULTS: Data collection started on July 30, 2024, for study 1 and on February 10, 2025, for study 2. A total of 100 participants were enrolled in MyChoice study 1, and 50 participants were enrolled in MyChoice study 2. Study follow-up has been completed. Data analysis is expected to be completed by November 2025. CONCLUSIONS: The MyChoice pilot studies will provide critical evidence on a novel intervention for PrEP decision-making during pregnancy and breastfeeding. If feasible and acceptable, these results will form the basis for larger efficacy trials to promote PrEP uptake during pregnancy. TRIAL REGISTRATION: ClinicalTrials.gov NCT06394323; https://clinicaltrials.gov/study/NCT06394323 and ClinicalTrials.gov NCT06397690; https://www.clinicaltrials.gov/study/NCT06397690. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/76442.

  PublisherDOI

• Understanding PrEP misconceptions and their impact on PrEP initiation and use among pregnant and lactating women in Malawi

  UNC Libraries · 2025-06-04

  articleOpen access

  Mother-to-child transmission (MTCT) of HIV remains a challenge in Eastern and Southern Africa. Oral pre-exposure prophylaxis (PrEP) is a powerful tool to reduce MTCT, but women face barriers to effective use including those related to inaccurate comprehension of PrEP To understand women’s misconceptions about PrEP and their potential impact on PrEP use, we conducted interviews with 33 pregnant and lactating women in Malawi using PrEP, and ten PrEP counselors and clinicians. The results indicate that, although pregnant women generally understood PrEP’s features and functions, many held misconceptions that persisted over the course of their PrEP use and impacted their perceptions and use of the medication. Some women erroneously believed that PrEP could treat and prevent sexually transmitted infections other than HIV, which motivated some to keep taking PrEP while motivating others to stop using PrEP once their STI had resolved. Some were confused about PrEP’s function, with some believing it was the same as antiretroviral therapy for HIV treatment, and others believing that PrEP could be used for overall enhancement of health. Rarer misconceptions included fears that PrEP was connected to satanic practices, could cause cancer, or was solely for individuals engaged in sex work. These misconceptions stemmed from a mix of prior knowledge, societal influences, and miscommunications during counseling sessions. Ensuring accurate knowledge and addressing common misconceptions head-on is crucial to promote continued PrEP use among women. Both clinic- and community-based communication efforts with a particular focus on the difference between PrEP, STI treatments, and ART are needed.

  PublisherDOI

• How Religion, Social Class, and Race Intersect in the Shaping of Young Women’s Understandings of Sex, Reproduction, and Contraception

  UNC Libraries · 2025-07-15

  articleOpen accessSenior author

  Using a complex religion framework, this study examines how and why three dimensions of religiosity-biblical literalism, personal religiosity, and religious service attendance-are related to young women's reproductive and contraceptive knowledge differently by social class and race. We triangulate the analysis of survey data from the Relationship Dynamics and Social Life study (RDSL) and semi-structured interview data from the National Study of Youth and Religion (NSYR) to identify and explain patterns. From the quantitative data, we find that all three dimensions of religiosity link to young women's understandings of sex, reproduction, and contraception in unique ways according to parental education and racial identity. There is a lack of knowledge about female reproductive biology for young women of higher SES with conservative Christian beliefs (regardless of race), but personal religiosity and religious service attendance are related to increased contraceptive knowledge for young black women and decreased knowledge for young white women. From the qualitative data, we find that class and race differences in the meaning of religion and how it informs sexual behavior help explain results from the quantitative data. Our results demonstrate the importance of taking a complex religion approach to studying religion and sex-related outcomes.

  PublisherDOI

• Understanding PrEP decision making among pregnant women in Lilongwe, Malawi: A mixed-methods study

  UNC Libraries · 2024-07-09

  articleOpen access

  INTRODUCTION: Pre-exposure prophylaxis (PrEP) is a promising tool for HIV prevention during pregnancy. With increasing rollout in antenatal settings, counselling strategies to help pregnant women make appropriate decisions about PrEP use are needed. Understanding women's motivations and concerns for PrEP use-and how these inform their decision making and feelings about the decision to start PrEP-are critical to inform these strategies. METHODS: We conducted a convergent mixed-methods study from June 2020 to June 2021 in the context of a PrEP adherence support trial among HIV-negative pregnant women in Lilongwe, Malawi. Two hundred women completed a survey reporting their motivations and concerns about PrEP use, and their feelings about the decision to start PrEP (Decisional Regret Scale). Thirty women completed in-depth interviews to better understand the decision-making process, including motivations and concerns weighed in women's decision to use PrEP. Analyses comprised descriptive and bivariate statistics, thematic qualitative analysis, and integration of quantitative and qualitative results. RESULTS: Women initiating PrEP during pregnancy were highly motivated to obtain HIV protection for themselves and their unborn child, often due to perceived HIV risk connoted by a recent sexually transmitted infection and/or concerns about partner non-monogamy. These motivations prevailed despite some concerns about safety and side effects, anticipated stigmatization, and concerns about adherence burden and pill attributes. Many women had informed their partner of their decision to use PrEP yet few felt their decision was contingent upon partner approval. Most women felt positively about the decision to start PrEP (mean decisional regret = 1.2 out of 5), but those with a greater number of concerns reported greater decisional regret (B = 0.036; p = 0.005). Furthermore, women who were specifically concerned about partner disclosure, who disliked pills or who had no perceived HIV risk reported greater decisional regret. CONCLUSIONS: Pregnant women were strongly motivated by the promise of HIV protection offered by PrEP and accepted it despite diverse concerns. A shared decision-making approach that centres pregnant women and offers partner involvement may help identify and address initial concerns about PrEP use and support prevention-effective use of PrEP during this important period.

  PublisherDOI

• How Early Life Religious Exposure Relates to the Timing of First Birth

  UNC Libraries · 2024-08-22

  articleOpen accessSenior author

  This paper examines intermediary processes explaining how religious socialization and involvement early in life are related to the timing of first births for women in the United States. The theory of conjunctural action forms the basis for hypotheses for how religious schema and materials operate to influence birth timing. Using the NLSY79 data and event history methods, the study finds evidence for expected family size, work-family gender ideology, educational attainment and enrollment, cohabitation, and age at marriage as mediators of associations between early life religious exposure (affiliation and attendance) and the timing of nonmaritally and maritally conceived first births. These findings corroborate other research identifying the long reach of religious socialization and involvement in youth, elucidate some of the pathways for these connections, and motivate further work to understand linkages between religion and family behaviors in the United States.

  PublisherDOI

• One Hundred Years of Religion in<i>Social Forces</i>

  Social Forces · 2023-04-01 · 2 citations

  articleOpen access1st authorCorresponding

  the founder of Social Forces (SF), felt strongly that religion was a significant social force in need of better understanding.This is readily apparent in the number of pages devoted to the topic in the journal's first few issues.From the start, Odum recognized the risks and challenges of trying to foster balanced and objective discussions of religious matters.In his first set of "Editorial Notes," he exhorts, Shall we always be torn between the unreasoning and unreasonable dogmatism of those who are blind to the progressive keynote of the Great Teacher, and of the equally limited dogmatism of those who wish to eliminate the primary functions of the church?To what extent is it possible for this Journal and others to cooperate in constructive work done rather than in creeds and dogmas, which may well be left to the technique of specialists?The contributions in this issue are consistent beginnings (Odum 1922: 59).

  PublisherOA PDFDOI

• Male partners’ support and influence on pregnant women’s oral PrEP use and adherence in Malawi

  Frontiers in Reproductive Health · 2023-08-08 · 16 citations

  articleOpen access

  Introduction: Daily oral pre-exposure prophylaxis (PrEP) is a safe and effective HIV prevention method for pregnant and postpartum women, but adherence barriers exist. Understanding the role of male partners in supporting PrEP use may inform strategies to support PrEP adherence among pregnant and breastfeeding women. Methods: = 20) in the context of a PrEP adherence trial. Women were purposively recruited to ensure variation in their partners' HIV status. Interviews were conducted in Chichewa using a semistructured guide. We followed a thematic approach to analyze the interview data. Results: Most male partners were receptive to women using PrEP during pregnancy because it eased their fears of the woman and baby acquiring HIV. Men often played a key role in women's PrEP adherence by providing daily reminders and encouragement to adhere to their medication. The majority of women appreciated this support from the men as it lessened the burden of remembering to take their medications daily on their own and aided their adherence. However, several women who lacked male partner support spoke of wanting their partners to be more involved. Many men living with HIV found the mutual support beneficial for their antiretroviral therapy adherence, while men without HIV or with status unknown appreciated knowing that the family was protected. While most men were open to women continuing PrEP beyond the current study, some would only support it if women were still at risk for acquiring HIV. Conclusion: In this study, male partners were strongly motivated to support the PrEP adherence of their female partners as a way of ensuring that the pregnant women and unborn babies were protected against HIV. Promoting disclosure and tangible support that arises organically among men may be helpful, but programs to enhance this support and identify ways to support women who do not receive support from their partners or do not wish to disclose their PrEP use to partners may be needed.

  PublisherOA PDFDOI

Recent grants

• Population Research Training

  NIH · $17.2M · 1979–2029

Frequent coauthors

• William G. Axinn

  University of Michigan–Ann Arbor

  16 shared

• Glen H. Elder

  University of North Carolina at Chapel Hill

  16 shared

• Richard A. Settersten

  Oregon State University

  16 shared

• Melinda Lundquist Denton

  14 shared

• Jessica Halliday Hardie

  City University of New York

  6 shared

• George M. Hayward

  Pennsylvania State University

  5 shared

• E. Michael Foster

  Heartlands Hospital

  4 shared

• Claire Chipman Gilliland

  Furman University

  4 shared