Pre-exposure prophylaxis (PrEP) awareness, use, and discontinuation among Lake Victoria fisherfolk in Uganda

A cross-sectional population-based study

Bibliographic Data

ID19593166
AuthorsKauthrah Ntabadde (0000-0002-6130-6535, Johns Hopkins University), Joseph Kagaayi (0000-0003-4101-3038, Rakai Health Sciences Program), Victor Ssempijja (0000-0003-2609-6525, Rakai Health Sciences Program), Xinyi Feng (0009-0009-6271-4811, Johns Hopkins University), Robert Kairania (0000-0002-9015-7209, Rakai Health Sciences Program), Joseph Lubwama (Rakai Health Sciences Program), Robert Ssekubugu (0000-0003-1245-4774, Rakai Health Sciences Program), Ping Teresa Yeh (0000-0002-7425-0382, Johns Hopkins University), Joseph Ssekasanvu (0000-0002-3721-2299, Johns Hopkins University), Aaron A R Tobian (0000-0002-0517-3766, Johns Hopkins University), Caitlin E Kennedy (0000-0001-6820-063X, Johns Hopkins University), Lisa A Mills (0000-0001-5674-9166, Centers for Disease Control and Prevention), Stella Alamo (0000-0003-4404-1181, Centers for Disease Control and Prevention), Philip Kreniske (0000-0002-1540-0651, City University of New York), John Santelli (0000-0003-2768-1910, Columbia University), Lisa Nelson (0000-0002-0305-2952, Centers for Disease Control and Prevention), Lisa J Nelson, Steven J Reynolds (0000-0002-5403-2759, National Institutes of Health), Larry W Chang (0000-0001-7985-4567, Johns Hopkins University), Gertrude Nakigozi (0000-0001-6193-2790, Rakai Health Sciences Program), M Kate Grabowski (0000-0002-4451-3436, Johns Hopkins University)
EditorsCollins Otieno Asweto (0000-0003-3514-9836)
Year2025
Volume5
Issue5
Pagese0003994
Publication date2025-05-09
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0003994
PMID40343955
OpenAlexW4410230146
LanguageEN
References cited31

There is 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. 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 awareness, 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. 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 = 1,166/1363) participants reported PrEP awareness, but few (14.5%; n = 197/1363) reported ever using PrEP. Among 47.7% (375/786) of men and 29.3% (169/577) of women PrEP-eligible at time of survey, 18.9% (n = 71/375) and 27.8% (n = 47/169) reported ever using PrEP, respectively. Over half (52.3%, n = 103/197) of those who had ever used PrEP, self-reported current use. 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

Cross-sectional study · Discontinuation · Environmental health · Family medicine · Men who have sex with men · Poisson regression · Population · Pre-exposure prophylaxis · Adolescent Sexual and Reproductive Health · Demography · HIV/AIDS Research and Interventions · Medicine · Sex work and related issues · Internal Medicine