Willingness to Take Pre-Exposure Prophylaxis (PrEP) among High-Risk Young Men aged 10-24 years in Masese Fishing Community, Jinja District, Uganda

  • Sexually Transmitted Diseases
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Globally, Pre-Exposure Prophylaxis (PrEP) is an HIV prevention strategy for high-risk populations including fishing communities. However, some communities have not embraced PrEP. We therefore assessed willingness to take PrEP among high-risk young men and their understanding of PrEP in a fishing community in Uganda.

We conducted a cross-sectional study, between October and November 2020, using quantitative and qualitative data collection methods among young men aged 10-24 years in Masese fishing community, Eastern Uganda. We surveyed 479 young men, who had two or more sexual partners with inconsistent or no condom use. Participants who reported they would take PrEP when provided were categorized as willing. We also conducted four focus group discussions (n=32) among a purposive sample of young men to explore understanding of PrEP. We conducted multivariable modified Poisson regression for the quantitative and thematic analysis for qualitative data.

Overall, 86.4% (n=414/479) of the participants were willing to take PrEP. Willingness to take PrEP was significantly lower among single/never married participants compared to the married (adjusted Prevalence Ratio (aPR)=0.92;95%CI:0.87,0.98). Willingness to take PrEP was higher among participants who self-perceived to be high-risk for HIV (aPR=1.11;95%CI:1.03,1.20); perceived less PrEP side-effects (aPR=1.56;95%CI:1.55,2.24) and would obtain PrEP within their community (aPR=1.40;95%CI:1.25,1.57). From the discussions, participants described PrEP as a drug used to prevent HIV, but some could not differentiate PrEP from Post-Exposure Prophylaxis and did not know when it was taken. Some participants feared that PrEP would lead to loss of libido while some feared it would increase sexual activity and expose them to other venereal diseases.

There was high willingness to take PrEP among young men in fishing communities. Strategies to improve PrEP interventions may be more effective if they target single men and provision of PrEP within such communities. Health education will also improve understanding of PrEP and promote risk awareness.

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