Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct 28;15(10):e0241399.
doi: 10.1371/journal.pone.0241399. eCollection 2020.

Knowledge and barriers of PrEP delivery among diverse groups of potential PrEP users in Central Uganda

Timothy R Muwonge  1 , Rogers Nsubuga  1 , Charles Brown  1 , Agnes Nakyanzi  1 , Monica Bagaya  1 , Felix Bambia  1 , Elly Katabira  2 , Peter Kyambadde  3   4 , Jared M Baeten  5 , Renee Heffron  5 , Connie Celum  5 , Andrew Mujugira  1 , Jessica E Haberer  6
Affiliations

Knowledge and barriers of PrEP delivery among diverse groups of potential PrEP users in Central Uganda

Timothy R Muwonge et al. PLoS One. .

Abstract

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.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Participant flow.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Chou R, Evans C, Hoverman A, Sun C, Dana T, et al. (2019) Preexposure prophylaxis for the prevention of HIV infection: evidence report and systematic review for the US Preventive Services Task Force. Jama 321: 2214–2230. 10.1001/jama.2019.2591 - DOI - PubMed
    1. Fonner VA, Dalglish SL, Kennedy CE, Baggaley R, O’reilly KR, et al. (2016) Effectiveness and safety of oral HIV preexposure prophylaxis for all populations. AIDS (London, England) 30: 1973 10.1097/QAD.0000000000001145 - DOI - PMC - PubMed
    1. Haberer JE (2016) Current concepts for PrEP adherence: In the PrEP revolution; from clinical trials to routine practice. Current Opinion in HIV and AIDS 11: 10 10.1097/COH.0000000000000220 - DOI - PMC - PubMed
    1. WHO (2018) Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV: interim guidelines: supplement to the 2016 consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. World Health Organization.
    1. McCormack SM, Noseda V, Molina JM (2016) PrEP in Europe—expectations, opportunities and barriers. J Int AIDS Soc 19: 21103 10.7448/IAS.19.7.21103 - DOI - PMC - PubMed

Publication types

MeSH terms