Low awareness and use of pre-exposure prophylaxis among adolescents and young adults in high HIV and sexual violence prevalence settings

Anthony Idowu Ajayi, Elmon Mudefi, Mohammed Sanusi Yusuf, Oladele Vincent Adeniyi, Ntombana Rala, Daniel Ter Goon, Anthony Idowu Ajayi, Elmon Mudefi, Mohammed Sanusi Yusuf, Oladele Vincent Adeniyi, Ntombana Rala, Daniel Ter Goon

Abstract

South Africa has adopted pre-exposure prophylaxis (PrEP) as a preventive strategy for populations at-risk for HIV, though uptake is low among adolescents and young adults. We examined the awareness and use of PrEP among adolescents and young adults in the Eastern Cape, South Africa.This cross-sectional study was conducted between June and November 2018 among 772 adolescents and young adults (aged 16-24 years) selected using stratified random sampling in a South African university. An electronic self-administered questionnaire was used to elicit demographic information, behavioral, family-related characteristics, awareness and use of PrEP. Adjusted and unadjusted logistic regression models were used to examine the predictors of PrEP awareness.The overall level of PrEP awareness was 18.8%; however, only 1.7% of participants had used PrEP, 7.5% of had seen it, 4.8% knew how much it cost, and 14.8% knew where and how to get it. In the adjusted regression analysis, only adequate family support (AOR: 2.11; CI: 1.47-3.04) and discussions of HIV and sexually transmitted infections with sexual partners (AOR: 1.78; CI: 1.19-2.67) were associated with a higher likelihood of being aware of PrEP.The level of awareness and use of PrEP is still very low among adolescents and young adults who may need it to prevent HIV infection. Poor awareness of PrEP among adolescents and young adults in high HIV risk settings may limit its use. Thus, concerted efforts are needed to promote awareness and access to PrEP among young South African adults.

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

References

    1. Flash CA, Frost EL, Giordano TP, et al. HIV Pre-exposure prophylaxis program implementation using intervention mapping. Am J Prevent Med 2018;54:519–29..
    1. McCormack S, Dunn DT, Desai M, et al. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet 2016;387:53–60..
    1. Donnell D, Baeten JM, Bumpus NN, et al. HIV protective efficacy and correlates of tenofovir blood concentrations in a clinical trial of PrEP for HIV prevention. J Acquir Immun Defic Syndr (1999) 2014;66:340–8..
    1. Jaspal R, Nerlich B. Polarised press reporting about HIV prevention: Social representations of pre-exposure prophylaxis in the UK press. Health 2017;21:478–97..
    1. Wilton J, Senn H, Sharma M, et al. Pre-exposure prophylaxis for sexually-acquired HIV risk management: a review. HIV/AIDS (Auckland, NZ) 2015;7:125.
    1. World Health Organization Consolidated Guidelines on HIV Prevenfion, Diagnosis, Treatment, and Care for Key Populafions: 2016 Update. Geneva: WHO; 2018.
    1. UNAIDS. UNAIDS Data 2018. Geneva: UNIADS; 2018. (Available at: ).
    1. Kharsany AB, Karim QA. HIV infection and AIDS in Sub-Saharan Africa: current status, challenges and opportunities. Open AIDS J 2016;10:34.
    1. UNAIDS. The Gap Report. Geneva: UNAIDS; 2014. (Available at: ).
    1. Eaton LA, Driffin DD, Bauermeister J, et al. Minimal awareness and stalled uptake of pre-exposure prophylaxis (PrEP) among at risk, HIV-negative, black men who have sex with men. AIDS Patient Care STDs 2015;29:423–9..
    1. Auerbach JD, Kinsky S, Brown G, et al. Knowledge, attitudes, and likelihood of pre-exposure prophylaxis (PrEP) use among US women at risk of acquiring HIV. AIDS Patient Care STDs 2015;29:102–10..
    1. Eaton LA, Matthews DD, Driffin DD, et al. A multi-US city assessment of awareness and uptake of pre-exposure prophylaxis (PrEP) for HIV prevention among Black men and transgender women who have sex with men. Prevent Sci 2017;18:505–16..
    1. National Department of Health Guidelines for expanding combination prevention and treatment options for sex workers: Oral pre-exposure prophylaxis (PrEP) and test and treat (T&T). Final Draft 2016;11:2016.
    1. National Department of Health. PrEP Implementation Pack: South Africa 2016-2017. Pretoria, South Africa: National Department of Health; 2017. ()
    1. Jewkes R, Sikweyiya Y, Morrell R, et al. The relationship between intimate partner violence, rape and HIV amongst South African men: a cross-sectional study. PloS One 2011;6:1–6..
    1. Hatcher AM, Colvin CJ, Ndlovu N, et al. Intimate partner violence among rural South African men: alcohol use, sexual decision-making, and partner communication. Cult Health Sexuality 2014;16:1023–39..
    1. Cohen C, Moyes J, Tempia S, et al. Severe influenza-associated respiratory infection in high HIV prevalence setting, South Africa, 2009-2011. Emerg Infect Dis 2013;19:1766–74..
    1. Sage, Saks M, Allsop J. Researching health: qualitative, quantitative and mixed methods:. 2012.
    1. Ajayi AI, Nwokocha EE, Akpan W, et al. “It's Sweet Without Condom”: Understanding Risky Sexual Behaviour Among Nigerian Female University Students. Online J Health Allied Scs 2017;16:9.
    1. Wheelock A, Eisingerich AB, Gomez GB, et al. Views of policymakers, healthcare workers and NGOs on HIV pre-exposure prophylaxis (PrEP): a multinational qualitative study. BMJ Open 2012;2:1–1..
    1. Restar AJ, Tocco JU, Mantell JE, et al. Perspectives on HIV pre-and post-exposure prophylaxes (PrEP and PEP) among female and male sex workers in Mombasa, Kenya: implications for integrating biomedical prevention into sexual health services. AIDS Educat Prevent 2017;29:141–53..
    1. Ajayi AI, Ismail KO, Adeniyi OV, et al. Awareness and use of pre-exposure and postexposure prophylaxes among Nigerian university students: findings from a cross-sectional survey. Medicine 2018;97:1–6..
    1. Eakle R, Bourne A, Mbogua J, et al. Exploring acceptability of oral PrEP prior to implementation among female sex workers in South Africa. J Int AIDS Soc 2018;21:1–7..
    1. Ramphele LPW. “Doing” gender in South Africa: footprints of tension for transgender persons [Full Dissertation]. Pretoria: University of South Africa; 2016.
    1. Mayer KH, Hosek S, Cohen S, et al. Antiretroviral pre-exposure prophylaxis implementation in the United States: a work in progress. J Int AIDS Soc 2015;18:1–7..
    1. Rice E, Barman-Adhikari A, Milburn NG, et al. Position-specific HIV risk in a large network of homeless youths. Am J Public Health 2012;102:141–7..
    1. Hoagland B, De Boni RB, Moreira RI, et al. Awareness and willingness to use pre-exposure prophylaxis (PrEP) among men who have sex with men and transgender women in Brazil. AIDS Behav 2017;21:1278–87..
    1. Young I, Li J, McDaid L. Awareness and willingness to use HIV pre-exposure prophylaxis amongst gay and bisexual men in Scotland: implications for biomedical HIV prevention. PloS One 2013;8:1–7..
    1. Ajayi AI, Abioye AO, Adeniyi OV, et al. Concerns about contracting HIV, knowing partners’ HIV sero-status and discussion of HIV/STI with sexual partners as determinants of uptake of HIV testing. J Biosoc Sci 2018;51:549–61..
    1. Haidar A, Ranjit N, Archer N, et al. Parental and peer social support is associated with healthier physical activity behaviors in adolescents: a cross-sectional analysis of Texas School Physical Activity and Nutrition (TX SPAN) data. BCM Public Health 2019;19:1–9..
    1. Chakrapani V, Newman PA, Shunmugam M, et al. Acceptability of HIV pre-exposure prophylaxis (PrEP) and implementation challenges among men who have sex with men in India: a qualitative investigation. AIDS Patient Care STDs 2015;29:569–77..

Source: PubMed

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