Predictors of oral pre-exposure prophylaxis (PrEP) uptake among individuals in a HIV vaccine preparedness cohort in Masaka, Uganda.
Predictors of oral pre-exposure prophylaxis (PrEP) uptake among individuals in a HIV vaccine preparedness cohort in Masaka, Uganda.
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DOI：
10.1097/md.0000000000027719
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发表时间：
2021-11-05
期刊：
影响因子：
1.6
通讯作者：
Ruzagira E
中科院分区：
文献类型：
--
作者：
Kusemererwa S;Kansiime S;Mutonyi G;Namirembe A;Katana S;Kitonsa J;Kakande A;Okello JM;Kaleebu P;Ruzagira E
口服暴露前预防（PrEP）可显著降低人类免疫缺陷病毒（HIV）感染风险。然而，撒哈拉以南非洲PrEP吸收预测因素的数据有限。我们评估了参加乌干达马萨卡艾滋病毒疫苗准备研究的未感染艾滋病毒的高危人群中PrEP摄入的预测因素。在2018年7月至2020年10月期间，我们招募了来自跨非洲高速公路沿着性工作热点和维多利亚湖渔业社区的成年人（18-40岁）。 我们收集了有关社会人口统计学和PrEP意识的基线数据，并在季度访问时提供艾滋病毒咨询和检测，PrEP信息和PrEP转介。每6个月进行一次尿妊娠试验（女性）和性风险行为和PrEP摄取数据收集。 我们分析了完成6个月随访的参与者的PrEP摄取情况。 在588名队列参与者中，362名（62%）被纳入本分析。其中女性176人（49%），年龄≤24岁181人（50%），性工作热点104人（29%），渔民74人（20%）。 只有75名（21%）参与者启动了PrEP。PrEP摄入的预测因素包括有≥6个性伴侣（调整后的比值比[aOR]= 2.29; 95%置信区间[CI] 1.26-4.17），从事性交易（aOR = 2.23; 95% CI 0.95-5.20）和居住在非渔业社区（aOR = 2.40; 95% CI 1.14-5.08）。 不开始PrEP的最常见原因是药丸负担（38%）和需要更多时间来决定（27%）。PrEP摄取率较低，与该队列中的艾滋病毒风险指标相关。需要采取干预措施，以改善PrEP的获得，特别是在渔业社区。
Oral pre-exposure prophylaxis (PrEP) significantly reduces human immunodeficiency virus (HIV) acquisition risk. However, data on predictors of PrEP uptake in sub-Saharan Africa are limited. We assessed predictors of PrEP uptake among HIV-uninfected high risk individuals enrolled in a HIV vaccine preparedness study in Masaka, Uganda. Between July 2018 and October 2020, we recruited adults (18–40 years) from sex work hotspots along the trans-African highway and Lake Victoria fishing communities. We collected baseline data on socio-demographics and PrEP awareness, and provided HIV counselling and testing, information on PrEP, and PrEP referrals at quarterly visits. Urine pregnancy tests (women) and data collection on sexual risk behaviour and PrEP uptake were performed every 6 months. We analysed PrEP uptake among participants who had completed 6 months of follow-up. Of the 588 cohort participants, 362 (62%) were included in this analysis. Of these, 176 (49%) were female, 181 (50%) were aged ≤24 years, 104 (29%) worked in sex work hotspots, 74 (20%) were fisher folk. Only 75 (21%) participants initiated PrEP. Predictors of PrEP uptake included having ≥6 sex partners (adjusted odds ratio [aOR] = 2.29; 95% confidence interval [CI] 1.26–4.17), engaging in transactional sex (aOR = 2.23; 95% CI 0.95–5.20), and residence in a nonfishing community (aOR = 2.40; 95% CI 1.14–5.08). The commonest reasons for not starting PrEP were pill burden (38%) and needing more time to decide (27%). PrEP uptake was low and associated with HIV risk indicators in this cohort. Interventions are needed to improve access to PrEP especially in fishing communities.