Pre-exposure prophylaxis (PrEP) knowledge, use, and discontinuation among Lake Victoria fisherfolk in Uganda: a cross-sectional population-based study.

Autor:	Ntabadde K; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Kagaayi J; Rakai Health Sciences Program, Kalisizo, Uganda.; Makerere University School of Public Health, Kampala, Uganda., Ssempijja V; Rakai Health Sciences Program, Kalisizo, Uganda.; Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA., Feng X; Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA., Kairania R; Rakai Health Sciences Program, Kalisizo, Uganda., Lubwama J; Rakai Health Sciences Program, Kalisizo, Uganda., Ssekubugu R; Rakai Health Sciences Program, Kalisizo, Uganda., Yeh PT; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Ssekasanvu J; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Tobian AAR; Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA., Kennedy CE; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Mills LA; United States Centers for Disease Control and Prevention, Uganda, Division of Global HIV & TB, Kampala Uganda., Alamo S; United States Centers for Disease Control and Prevention, Uganda, Division of Global HIV & TB, Kampala Uganda., Kreniske P; Community Health and Social Sciences Department, Graduate School of Public Health and Health Policy, City University of New York (CUNY)., Santelli J; Department of Population and Family Health and Pediatrics, Columbia University Mailman School of Public Health, New York, New York, USA., Nelson LJ; United States Centers for Disease Control and Prevention, Uganda, Division of Global HIV & TB, Kampala Uganda., Reynolds SJ; Rakai Health Sciences Program, Kalisizo, Uganda.; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.; Division of Infectious Diseases, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA., Chang LW; Rakai Health Sciences Program, Kalisizo, Uganda.; Division of Infectious Diseases, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA., Nakigozi G; Rakai Health Sciences Program, Kalisizo, Uganda., Grabowski MK; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.; Rakai Health Sciences Program, Kalisizo, Uganda.; Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Jazyk:	angličtina
Zdroj:	MedRxiv : the preprint server for health sciences [medRxiv] 2024 Mar 30. Date of Electronic Publication: 2024 Mar 30.
DOI:	10.1101/2024.03.29.24305076
Abstrakt:	Background: There are limited population-level data on the pre-exposure prophylaxis (PrEP) care continuum in eastern Africa. Here, we assessed the PrEP care continuum following PrEP rollout in a Ugandan community with ~40% HIV seroprevalence. Methods: We used cross-sectional population-based data collected between September 3 and December 19, 2018 from a Lake Victoria fishing community in southern Uganda to measure levels of self-reported PrEP knowledge, ever use, and discontinuation following 2017 PrEP rollout via a U.S. President's Emergency Plan for AIDS Relief (PEPFAR)-supported phased implementation program. Our analysis included HIV-seronegative persons reporting having ever received an HIV test result. We examined associations between demographic, behavioral, and health utilization factors with each outcome using age-adjusted modified Poisson regression. Results: There were 1,401 HIV-seronegative participants, of whom 1,363 (97.3%) reported ever receiving an HIV test result. Median age was 29 years (IQR: 23-36), and 42.3% (n=577) were women. Most (85.5%; n=1,166) participants reported PrEP knowledge, but few (14.5%; n=197) reported ever using PrEP. Among 375 (47.7%) men and 169 (29.3%) women PrEP-eligible at time of survey, 18.9% (n=71) and 27.8% (n=47) reported ever using PrEP, respectively. Over half (52.3%, n=103) of those who had ever used PrEP, self-reported current use. Conclusion: In this Lake Victoria fishing community, there were low levels of PrEP use despite high levels of PrEP awareness and eligibility, particularly among men. Efforts that enhance awareness of HIV risk and increase PrEP accessibility may help increase PrEP use among HIV-seronegative persons in African settings with high HIV burden. Competing Interests: Conflicts of Interest and Source of Funding: The authors declare no conflicts of interest. The Rakai Community Cohort Study round 19 was supported by the National Institute of Mental Health (R01MH099733, R01MH105313, R01MH107275, R01MH115799), National Institute of Allergy and Infectious Diseases (R01AI114438, K25AI114461, R01AI123002, K01AI125086, R01AI128779, R01AI143333), National Institute on Alcohol Abuse and Alcoholism (K01AA024068), Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD091003) and the Bill and Melinda Gates Foundation (OPP1175094). The study was also supported in part by the Division of Intramural Research, National Institute of Allergy and Infectious Diseases. KN received training and support from the National Institutes of Health Fogarty International Center (D43TW010557). The funders were not involved in the design of the study and collection, analysis, and interpretation of data or in writing the manuscript. This study has also been supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through CDC under the terms of NU2GGH002009.
Databáze:	MEDLINE
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