Examining oral pre-exposure prophylaxis (PrEP) literacy among participants in an HIV vaccine trial preparedness cohort study

Rujeko Samanthia Chimukuche, Rachel Kawuma, Nteboheleng Mahapa, Smanga Mkhwanazi, Nishanta Singh, Samantha Siva, Eugene Ruzagira, Janet Seeley, PrEPVacc Study Group, Glenda Gray, Nishanta Singh, Zakir Gaffoor, Neetha Morar, Thandiwe Sithole, Kubashni Woeber, Samantha Siva, Eldinah Hwengwere, Rujeko Samanthia Chidawanyika, Nteboheleng Mahapa, Phindile Khanyile, Ilesh Jani, Edna Viegas, Isabel Remane, Odete Bule, Edna Nhacule, Patricia Ramgi, Raquel Chissumba, Eduardo Namalango, Yolanda Manganhe, Carmelia Massingue, Igor Capitine, Jorge Ribeiro, Lucas Maganga, Wiston William, Emmanuel Kapesa, Elizabeth Danstan, Doreen Pamba, Marco Missanga Amani Kway, Abisai Kisinda, Lilian Njovu, Lwitiho Sudi, Revocatus Kunambi, Said Aboud, Patricia Munseri, Eligius Lyamuya, Frank Msafiri, Agricola Joachim, Edith Tarimo, Diana Faini Tumaini Nagu, Deus Buma, Muhammad Bakari, Pontiano Kaleebu, Freddie Mukasa Kibengo, Ayoub Kakande, Jennifer Serwanga, Rachel Kawuma, Christian Hansen Holmes, Sheila Kansiime, Eugene Ruzagira, Janet Seeley, Sylvia Kusemererwa, Sylvia Masawi, Vincent Basajja, Tobias Vudriko, Peter Hughes, Shamim Nabukenya, Gertrude Mutonyi, Rita Nakiboneka, Susan Mugaba, Jonathan Weber, Cherry Kingsley, Tom Miller, Sheena McCormack, Angela Crook, David Dunn, Henry Bern, Aminata Sy, Liz Brodnicki, Sarah Joseph, Claire Wenden, Kundai Chinyenze, Jacqueline Musau, Mabela Matsoso, Mary Amondi, Paramesh Chetty, Anne Gumbe, Giuseppe Pantaleo, Song Ding, Charlotta Nilsson, Arne Kroidl, Julie Fox, Gustavo Doncel, Allison Matthews, Jim Rooney, Carter Lee, Merlin Robb, Rujeko Samanthia Chimukuche, Rachel Kawuma, Nteboheleng Mahapa, Smanga Mkhwanazi, Nishanta Singh, Samantha Siva, Eugene Ruzagira, Janet Seeley, PrEPVacc Study Group, Glenda Gray, Nishanta Singh, Zakir Gaffoor, Neetha Morar, Thandiwe Sithole, Kubashni Woeber, Samantha Siva, Eldinah Hwengwere, Rujeko Samanthia Chidawanyika, Nteboheleng Mahapa, Phindile Khanyile, Ilesh Jani, Edna Viegas, Isabel Remane, Odete Bule, Edna Nhacule, Patricia Ramgi, Raquel Chissumba, Eduardo Namalango, Yolanda Manganhe, Carmelia Massingue, Igor Capitine, Jorge Ribeiro, Lucas Maganga, Wiston William, Emmanuel Kapesa, Elizabeth Danstan, Doreen Pamba, Marco Missanga Amani Kway, Abisai Kisinda, Lilian Njovu, Lwitiho Sudi, Revocatus Kunambi, Said Aboud, Patricia Munseri, Eligius Lyamuya, Frank Msafiri, Agricola Joachim, Edith Tarimo, Diana Faini Tumaini Nagu, Deus Buma, Muhammad Bakari, Pontiano Kaleebu, Freddie Mukasa Kibengo, Ayoub Kakande, Jennifer Serwanga, Rachel Kawuma, Christian Hansen Holmes, Sheila Kansiime, Eugene Ruzagira, Janet Seeley, Sylvia Kusemererwa, Sylvia Masawi, Vincent Basajja, Tobias Vudriko, Peter Hughes, Shamim Nabukenya, Gertrude Mutonyi, Rita Nakiboneka, Susan Mugaba, Jonathan Weber, Cherry Kingsley, Tom Miller, Sheena McCormack, Angela Crook, David Dunn, Henry Bern, Aminata Sy, Liz Brodnicki, Sarah Joseph, Claire Wenden, Kundai Chinyenze, Jacqueline Musau, Mabela Matsoso, Mary Amondi, Paramesh Chetty, Anne Gumbe, Giuseppe Pantaleo, Song Ding, Charlotta Nilsson, Arne Kroidl, Julie Fox, Gustavo Doncel, Allison Matthews, Jim Rooney, Carter Lee, Merlin Robb

Abstract

Background: PrEP literacy is influenced by many factors including the types of information available and how it is interpreted. The level of PrEP literacy may influence acceptability and uptake.

Methods: We conducted 25 in-depth interviews in a HIV vaccine trial preparedness cohort study. We explored what participants knew about PrEP, sources of PrEP knowledge and how much they know about PrEP. We used the framework approach to generate themes for analysis guided by the Social Ecological Model and examined levels of PrEP literacy using the individual and interpersonal constructs of the SEM.

Results: We found that PrEP awareness is strongly influenced by external factors such as social media and how much participants know about HIV treatment and prevention in the local community. However, while participants highlighted the importance of the internet/social media as a source of information about PrEP they talked of low PrEP literacy in their communities. Participants indicated that their own knowledge came as a result of joining the HIV vaccine trial preparedness study. However, some expressed doubts about the effectiveness of the drug and worried about side effects. Participants commented that at the community level PrEP was associated with being sexually active, because it was used to prevent the sexual transmission of HIV. As a result, some participants commented that one could feel judged by the health workers for asking for PrEP at health facilities in the community.

Conclusion: The information collected in this study provided an understanding of the different layers of influence around individuals that are important to address to improve PrEP acceptability and uptake. Our findings can inform strategies to address the barriers to PrEP uptake, particularly at structural and community levels.

Trial registration: https://ichgcp.net/clinical-trials-registry/NCT04066881.

Keywords: HIV; PrEP literacy; Pre-exposure prophylaxis.

Conflict of interest statement

N/A

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Modified Socio-Ecological Model levels of influence on PrEP literacy

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