Awareness of and willingness to use oral pre-exposure prophylaxis (PrEP) for HIV prevention among sexually active adults in Malawi: results from the 2020 Malawi population-based HIV impact assessment

BMC Infectious Diseases

Research

Andreas Jahn¹  Rose Nyirenda¹  Kristin Brown²  Pragna Patel²  Danielle Payne³  Fatima Zulu³  Nellie Wadonda-Kabondo³  Victor Singano³  Kelsey Mirkovic³  Andrew Auld³  Alice Maida³  Wezi Msungama³  Alinune Nathanael Kabaghe⁴  Mansoor Farahani⁵  Felix Kayigamba⁶  Francis Ogollah⁶  Lyson Tenthani⁶ 

[1] Department of HIV, AIDS and Hepatitis, Ministry of Health, Lilongwe, Malawi;Division of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, United States of America;Division of Global HIV and TB, Centers for Disease Control and Prevention, Lilongwe, Malawi;Division of Global HIV and TB, Centers for Disease Control and Prevention, Lilongwe, Malawi;Centers for Disease Control and Prevention, US Embassy - Lilongwe, P.O. Box 30016, 2nd Floor NICO House, Lilongwe, Malawi;ICAP Headquarters, Columbia University, New York, United States of America;ICAP in Malawi, Lilongwe, Malawi;

关键词: HIV;    PrEP;    HIV prevention;    Malawi;    Population survey;   

DOI  :  10.1186/s12879-023-08683-1

 received in 2023-06-13, accepted in 2023-10-08,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe World Health Organization recommends Pre-Exposure Prophylaxis (PrEP) for all populations at substantial risk of HIV infection. Understanding PrEP awareness and interest is crucial for designing PrEP programs; however, data are lacking in sub-Saharan Africa. In Malawi, oral PrEP was introduced in 2018. We analyzed data from the 2020 Malawi Population-based HIV Impact Assessment (MPHIA) to assess PrEP awareness and factors associated with PrEP interest in Malawi.MethodsMPHIA 2020 was a national cross-sectional household-based survey targeting adults aged 15 + years. Oral PrEP was first described to the survey participants as taking a daily pill to reduce the chance of getting HIV. To assess awareness, participants were asked if they had ever heard of PrEP and to assess interest, were asked if they would take PrEP to prevent HIV, regardless of previous PrEP knowledge. Only sexually active HIV-negative participants are included in this analysis. We used multivariable logistic regression to assess sociodemographic factors and behaviors associated with PrEP interest. All results were weighted.ResultsWe included 13,995 HIV-negative sexually active participants; median age was 29 years old. Overall, 15.0%, 95% confidence interval (CI): 14.2–15.9% of participants were aware of PrEP. More males (adjusted odds ratio (aOR): 1.3, 95% CI: 1.2–1.5), those with secondary (aOR: 1.5, 95% CI: 1.2-2.0) or post-secondary (aOR: 3.4, 95% CI: 2.4–4.9) education and the wealthiest (aOR: 1.6, 95% CI: 1.2-2.0) were aware of PrEP than female, those without education and least wealthy participants, respectively. Overall, 73.0% (95% CI: 71.8–74.1%) of participants were willing to use PrEP. Being male (aOR: 1.2; 95% CI: 1.1–1.3) and having more than one sexual partner (aOR: 1.7 95% CI: 1.4–1.9), were associated higher willingness to use PrEP.ConclusionsIn this survey, prior PrEP knowledge and use were low while PrEP interest was high. High risk sexual behavior was associated with willingness to use PrEP. Strategies to increase PrEP awareness and universal access, may reduce HIV transmission.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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