Engagement in the pre‐exposure prophylaxis (PrEP) cascade among a respondent‐driven sample of sexually active men who have sex with men and transgender women during early PrEP implementation in Zimbabwe
Rattachement africain : us, Zimbabwe, Ouganda. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
INTRODUCTION: Zimbabwe is scaling up pre-exposure prophylaxis (PrEP) for key populations, including men who have sex with men (MSM) and transgender women (TGW). To assess implementation and inform HIV programming, we evaluated gaps in PrEP awareness, uptake and use, and correlates of awareness and uptake among a sample of MSM, TGW and genderqueer individuals (GQ) in Harare and Bulawayo, Zimbabwe. METHODS: Respondent-driven sampling was used to recruit 1194 MSM and 344 TGW/GQ aged ≥18 to participate in a cross-sectional survey assessing HIV-related outcomes in 2019. Consenting participants completed a questionnaire on socio-demographic information, sexual risk practices and engagement in HIV services and underwent HIV testing. Descriptive statistics were used to assess the PrEP cascade. Multiple logistic regression models were used to identify factors associated with PrEP awareness and uptake among HIV-negative participants. Data were unweighted as the sample did not reach convergence on key estimates. RESULTS: Among the 1167 HIV-negative participants, most (79.2%) were MSM compared to TGW/GQ (20.8%). Median age was 24 years. Overall, 45.8% were aware of PrEP and of those, 31.3% had ever taken PrEP. Most (71.1%) reporting never taking PrEP were willing to start PrEP; the main reasons for never starting PrEP included not knowing where to access it (24.8%) and fearing side effects (20.4%). Among those who had ever taken PrEP, 74.9% had taken PrEP in the last 6 months; of these, 42.4% had taken PrEP the day of or day preceding the survey. Side effects represented the most common (59.5%) reason for discontinuing PrEP. MSM (adjusted odds ratio [aOR]: 2.5, 95% confidence interval [CI]: 1.8-3.6) and TGW/GQ in Harare (aOR: 3.1, 95% CI: 2.1-4.7), and TGW/GQ in Bulawayo (aOR: 2.4, 95% CI: 1.1-5.3) had higher awareness of PrEP than MSM in Bulawayo. Overall, TGW/GQ were more likely to have ever taken PrEP compared to MSM (aOR: 1.6, 95% CI: 1.01-2.4). CONCLUSIONS: Findings emphasize the need for tailored interventions to promote PrEP among key populations. As HIV programs in Zimbabwe continue to expand PrEP services, these data, including barriers to starting and continuing PrEP, can inform strategies to address gaps along the PrEP cascade.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Engagement in the pre‐exposure prophylaxis (PrEP) cascade among a respondent‐driven sample of sexually active men who have sex with men and transgender women during early PrEP implementation in Zimbabwe
- Date Crossref
- 01/02/2022
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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ICAP Global Health pays non établi dans la noticeÉtablissement de santé
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Columbia University Department of Epidemiology Harare, Zimbabwe (pays nommé en fin d’affiliation)Université ou école supérieure
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Ministry of Health and Child Welfare Zimbabwe (code pays fourni par la source)Organisme public
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Centers for Disease Control and Prevention Ouganda (code pays fourni par la source)Organisme public
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Catholic University of Zimbabwe Zimbabwe (code pays fourni par la source)Université ou école supérieure
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Centers for Disease Control and Prevention pays non établi dans la noticeOrganisme public
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Mailman School of Public Health Department of Epidemiology pays non établi dans la noticeUniversité ou école supérieure
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Zimbabwe Ministry of Health and Child Care Harare Zimbabwe Harare, Zimbabwe (pays nommé en fin d’affiliation)Organisme public
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Division of Global HIV & Harare, Zimbabwe (pays nommé en fin d’affiliation)Institution
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GALZ Harare Zimbabwe GALZ Harare Zimbabwe, Zimbabwe (pays nommé en fin d’affiliation)Institution
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Division of Global HIV & TB pays non établi dans la noticeInstitution
ICAP Global Health, Department of Epidemiology — Columbia University (Harare, Zimbabwe) et Ministry of Health and Child Welfare (Zimbabwe), avec 8 autres affiliations. Pays d’affiliation : Zimbabwe, Ouganda.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.