Chisquares Inc. Atlanta, Georgia, United States of America.
School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.
Pan Afr Med J. 2024 Jul 9;48:95. doi: 10.11604/pamj.2024.48.95.34137. eCollection 2024.
South Africa adopted for pre-exposure prophylaxis (PrEP) in 2016, becoming the first African country to do so. Yet to date, uptake has been underwhelming, only about 165,000 South Africans were reported to be on PrEP in mid-2021. Lack of awareness has been cited as a contributory factor for the low uptake, but this has never been examined using a nationally representative sample.
we investigated this among a national sample of HIV seronegative adults. Data were from the 2017/2018 South African National HIV Prevalence, Incidence, Behaviour and Communication Survey. Awareness and openness to using PrEP were self-reported. Weighted percentages were calculated overall and by demographic characteristics.
overall, only 3.2% of seronegative adults spontaneously reported PrEP as a way of preventing HIV. Overall, 69.6% were open to using PrEP, from 58.2% in Western Cape, to 78.5% Northern Cape. Openness was highest among the youngest age group (18-29 years, 78.3%) and lowest among the oldest (60+ years, 45.6%). Striking racial differences were observed with openness among Black Africans (75.4%) being 2.5 times higher than Whites (29.0%). Among women, openness was 64.7% among those currently pregnant, 80.4% among those pregnant in the past two years but not now, and 67.8% among those who were not pregnant in the past two years (χ(2)=134.2, p<0.001). Among males, openness was higher among those circumcised (75.6%) than uncircumcised (64.5%).
planning for broad-scale implementation of PrEP within the South African context could build on knowledge gained from recent implementation and scale-up of relevant biomedical interventions (e.g. ART, voluntary medical male circumcision, and family planning).
南非于 2016 年采用了暴露前预防（PrEP）措施，成为第一个这样做的非洲国家。然而，迄今为止，接受率一直不尽人意，据报道，到 2021 年年中，只有约 165000 名南非人正在接受 PrEP。缺乏意识被认为是接受率低的一个促成因素，但这从未使用全国代表性样本进行过检查。
我们在全国范围内的 HIV 血清阴性成年人中对此进行了调查。数据来自 2017/2018 年南非全国艾滋病毒流行率、发病率、行为和交流调查。知晓情况和对使用 PrEP 的开放程度是自我报告的。计算了总体和按人口统计学特征的加权百分比。
总体而言，只有 3.2%的血清阴性成年人自发报告 PrEP 是预防 HIV 的一种方式。总体而言，69.6%的人愿意使用 PrEP，从西开普省的 58.2%到北开普省的 78.5%。最年轻的年龄组（18-29 岁，78.3%）的开放性最高，而最年长的年龄组（60 岁以上，45.6%）的开放性最低。观察到明显的种族差异，其中黑非洲人（75.4%）的开放性是白人（29.0%）的 2.5 倍。在女性中，目前怀孕的人开放性为 64.7%，过去两年怀孕但现在不怀孕的人开放性为 80.4%，过去两年不怀孕的人开放性为 67.8%（χ²=134.2，p<0.001）。在男性中，接受割礼的人（75.6%）比未接受割礼的人（64.5%）的开放性更高。
在南非背景下，为 PrEP 的广泛实施做规划可以借鉴最近实施和扩大相关生物医学干预措施（如 ART、自愿男性割礼和计划生育）所获得的知识。
