Knowledge and barriers of PrEP delivery among diverse groups of potential PrEP users in Central Uganda.
Administration, Oral
Adult
Emtricitabine
/ administration & dosage
Female
HIV Infections
/ prevention & control
Health Knowledge, Attitudes, Practice
Health Services Accessibility
/ statistics & numerical data
Humans
Male
Patient Compliance
/ statistics & numerical data
Pre-Exposure Prophylaxis
/ statistics & numerical data
Surveys and Questionnaires
Tenofovir
/ administration & dosage
Uganda
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
04
06
2020
accepted:
13
10
2020
entrez:
28
10
2020
pubmed:
29
10
2020
medline:
22
12
2020
Statut:
epublish
Résumé
Scale-up of oral pre-exposure prophylaxis (PrEP) for HIV prevention in Uganda began with serodiscordant couples (SDC) and has expanded to other most at-risk populations (MARPs). We explored knowledge, acceptability, barriers and facilitators of PrEP use among potential PrEP users in four MARPs (SDC; men who have sex with men [MSM]; female sex workers [FSW], and fisher folk). We administered quantitative surveys to potential PrEP users in multiple settings in Central Uganda at baseline and approximately 9 months after healthcare worker (HCW) training on PrEP. The survey was completed by 250 potential PrEP users at baseline and 125 after HCW training; 55 completed both surveys. For these 250 participants, mean age was 28.5 years (SD 6.9), 47% were male and 6% were transgender women, with approximately even distribution across MARPs and recruitment locations (urban, peri-urban, and rural). Most (65%) had not heard about PrEP. After HCW training, 24% of those sampled were aware of PrEP, and the proportion of those who accurately described PrEP as "antiretrovirals to be used before HIV exposure" increased from 54% in the baseline survey to 74% in the second survey (p<0.001). The proportion of participants who reported HCW as a source of PrEP information increased after training (59% vs 91%, p<0.001). In both surveys, nearly all participants indicated they were willing to take PrEP if offered. The most common anticipated barriers to PrEP were stigma, transportation, accessibility, busy schedules, and forgetfulness. Closeness to home was a common facilitator for all participant categories. Initial awareness of PrEP was low, but PrEP knowledge and interest increased among diverse MARPs after HCW training. Demand creation and HCW training will be critical for increasing PrEP awareness among key populations, with support to overcome barriers to PrEP use. These findings should encourage the acceleration of PrEP rollout in Uganda.
Sections du résumé
BACKGROUND
Scale-up of oral pre-exposure prophylaxis (PrEP) for HIV prevention in Uganda began with serodiscordant couples (SDC) and has expanded to other most at-risk populations (MARPs). We explored knowledge, acceptability, barriers and facilitators of PrEP use among potential PrEP users in four MARPs (SDC; men who have sex with men [MSM]; female sex workers [FSW], and fisher folk).
METHODS
We administered quantitative surveys to potential PrEP users in multiple settings in Central Uganda at baseline and approximately 9 months after healthcare worker (HCW) training on PrEP.
RESULTS
The survey was completed by 250 potential PrEP users at baseline and 125 after HCW training; 55 completed both surveys. For these 250 participants, mean age was 28.5 years (SD 6.9), 47% were male and 6% were transgender women, with approximately even distribution across MARPs and recruitment locations (urban, peri-urban, and rural). Most (65%) had not heard about PrEP. After HCW training, 24% of those sampled were aware of PrEP, and the proportion of those who accurately described PrEP as "antiretrovirals to be used before HIV exposure" increased from 54% in the baseline survey to 74% in the second survey (p<0.001). The proportion of participants who reported HCW as a source of PrEP information increased after training (59% vs 91%, p<0.001). In both surveys, nearly all participants indicated they were willing to take PrEP if offered. The most common anticipated barriers to PrEP were stigma, transportation, accessibility, busy schedules, and forgetfulness. Closeness to home was a common facilitator for all participant categories.
CONCLUSIONS
Initial awareness of PrEP was low, but PrEP knowledge and interest increased among diverse MARPs after HCW training. Demand creation and HCW training will be critical for increasing PrEP awareness among key populations, with support to overcome barriers to PrEP use. These findings should encourage the acceleration of PrEP rollout in Uganda.
Identifiants
pubmed: 33112907
doi: 10.1371/journal.pone.0241399
pii: PONE-D-20-17048
pmc: PMC7592843
doi:
Substances chimiques
Tenofovir
99YXE507IL
Emtricitabine
G70B4ETF4S
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0241399Subventions
Organisme : NIMH NIH HHS
ID : K24 MH114732
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI027757
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH098744
Pays : United States
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Front Pharmacol. 2018 Sep 04;9:799
pubmed: 30233355
Gates Open Res. 2019 Jul 5;3:1504
pubmed: 31942537
AIDS Behav. 2013 Jul;17(6):2162-72
pubmed: 23080358
Curr Opin HIV AIDS. 2016 Jan;11(1):10-7
pubmed: 26633638
AIDS Patient Care STDS. 2013 Apr;27(4):248-54
pubmed: 23565928
MMWR Morb Mortal Wkly Rep. 2020 Feb 28;69(8):212-215
pubmed: 32107367
Am J Prev Med. 2013 Jan;44(1 Suppl 2):S91-8
pubmed: 23253769
AIDS Rev. 2019;21(3):170-171
pubmed: 31532400
BMC Infect Dis. 2018 Nov 16;18(1):581
pubmed: 30445925
AIDS. 2016 Jul 31;30(12):1973-83
pubmed: 27149090
Gates Open Res. 2017 Nov 6;1:3
pubmed: 29355231
JAMA. 2019 Jun 11;321(22):2214-2230
pubmed: 31184746
Curr Opin HIV AIDS. 2016 Jan;11(1):41-8
pubmed: 26417953
PLoS Med. 2016 Aug 23;13(8):e1002099
pubmed: 27552090
Drugs. 2019 Aug;79(12):1263-1276
pubmed: 31309457
Am J Public Health. 2020 Jan;110(1):61-64
pubmed: 31725314
J Int AIDS Soc. 2016 Oct 18;19(7(Suppl 6)):21103
pubmed: 27760681