Lunkuse Jane Frances, Lwanga Charles, Wamono Felix, Muturi-Kioi Vincent, Price Matt, Mayanja Yunia
Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Kampala, Uganda.
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AIDS Behav. 2025 May;29(5):1458-1469. doi: 10.1007/s10461-025-04616-y. Epub 2025 Jan 30.
Pre-exposure prophylaxis (PrEP) has proven to be a powerful tool in preventing HIV infection. There is limited information about the factors associated with willingness to use different PrEP modalities among adolescent girls and young women (AGYW) in Africa. We assessed willingness to use long-acting injectable PrEP (LAI-PrEP) among 14-24-year-old AGYW at high risk of HIV in Uganda, and associated factors determined using multivariable complementary log-log regression. Of the 285 participants, 69.8% of participants showed willingness to use LAI-PrEP despite only 3.9% having knowledge about it before enrolment. Report of recent transactional sex was high (92.6%). Participants that were divorced/separated (aOR = 1.74, 95% CI 1.03-2.92) and those with multiple sexual partners (aOR = 2.11, 95% CI 1.46-3.06) compared to those with one partner were more likely to be willing to use LAI-PrEP while those that were screened as heavy episodic drinkers (consuming 6 or more drinks on an occasion as per the AUDIT tool) were less likely to be willing to use LAI-PrEP (aOR = 0.61, 95% CI 0.42-0.87). LAI PrEP has shown efficacy in clinical trials; the product is approved for use by the Government of Uganda (MoH) and should be expedited for use by AGYW engaged in paid sex and those with multiple sexual partnerships. As it becomes available, we recommend PrEP education and counseling to increase awareness of LAI PrEP as an alternative HIV prevention method.
暴露前预防(PrEP)已被证明是预防艾滋病毒感染的有力工具。在非洲,关于少女和年轻女性(AGYW)中与使用不同PrEP方式意愿相关的因素的信息有限。我们评估了乌干达14至24岁处于艾滋病毒高风险的AGYW使用长效注射用PrEP(LAI-PrEP)的意愿,并使用多变量互补对数-对数回归确定相关因素。在285名参与者中,69.8%的参与者表示愿意使用LAI-PrEP,尽管在入组前只有3.9%的人了解它。近期交易性行为的报告率很高(92.6%)。与有一个性伴侣的参与者相比,离婚/分居的参与者(调整后比值比[aOR]=1.74,95%置信区间[CI]为1.03-2.92)和有多个性伴侣的参与者(aOR=2.11,95%CI为1.46-3.06)更有可能愿意使用LAI-PrEP,而被筛查为重度偶尔饮酒者(根据酒精使用障碍识别测试工具,一次饮用6杯或更多杯酒)的参与者愿意使用LAI-PrEP的可能性较小(aOR=0.61,95%CI为0.42-0.87)。LAI PrEP在临床试验中已显示出疗效;该产品已获乌干达政府(卫生部)批准使用,应加快供从事有偿性行为和有多个性伴侣的AGYW使用。随着该产品的推出,我们建议开展PrEP教育和咨询,以提高对LAI PrEP作为一种替代艾滋病毒预防方法的认识。