Omoding Alex, Opito Ronald, Oboth Paul, Okello Francis, Matovu Joseph K B
Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Mbale, Uganda.
Department of Health, Uganda Protestant Medical Bureau (UPMB), Kampala, Uganda.
PLoS One. 2025 Jun 4;20(6):e0317808. doi: 10.1371/journal.pone.0317808. eCollection 2025.
Despite the potential efficacy of Pre-Exposure Prophylaxis (PrEP) in reducing HIV risk, Oral PrEP acceptability remains strikingly varied by populations and locations. We assessed PrEP acceptability and associated factors among at-risk HIV-negative young men.
A cross-sectional analytical study design was used. Data were collected among 409 at-risk HIV-negative young men aged 15-24 years living in Kagwara fishing community-Serere district, Uganda between August and October 2023. Quantitative data were collected on socio-demographic characteristics, sexual risk behaviors and concerns about PrEP. Data was analyzed using Stata version 15.0 statistical software. Summary statistics were computed and presented as tables, frequencies and proportions. Bivariate analysis was conducted using binary logistic regression to identify independent factors associated with PrEP acceptability. All factors that had p < 0.10 at the bivariate analysis and confounders were entered into the final logistic regression model. All factors with p < 0.05 were considered significantly associated with the primary outcome.
The average age of 409 respondents was 21.8 (Standard Deviation [SD]=1.9) years. Majority, (97.8%, n = 393) had unprotected penetrative sex. PrEP acceptability was high as majority of the participants accepted to use PrEP based on the six constructs of acceptability (93.6%, n = 383). Participants with perceived risk of getting HIV infection had higher odds of PrEP acceptability, (adjusted odds ratio [aOR]=4.23, 95%CI = 1.05-17.04). Participants who knew their partner's HIV status (aOR=0.25, 95%CI = 0.07-0.88), those who felt embarrassed to ask for PrEP from the facility (aOR=0.12, 95%CI = 0.04-0.39), and those who had stigma associated with use of PrEP (aOR=0.13, 95%CI = 0.04-0.41) had reduced odds of PrEP acceptability.
We found a high level of PrEP acceptability among young men at risk of HIV acquisition in Kagwara fishing community. Improving access to PrEP services among high risk young men in the fishing communities may increase PrEP uptake in this population and across similar settings. The Ministry of health needs to use multiple approaches to provide PrEP such as peer-led models, drug distribution points, short message reminders for refills, pharmacies and retail drug shops.
尽管暴露前预防（PrEP）在降低艾滋病毒感染风险方面具有潜在疗效，但口服PrEP的可接受性在不同人群和地区仍存在显著差异。我们评估了有感染艾滋病毒风险的艾滋病毒阴性年轻男性对PrEP的可接受性及相关因素。
采用横断面分析研究设计。于2023年8月至10月期间，在乌干达塞雷雷区卡格瓦拉渔业社区生活的409名年龄在15 - 24岁、有感染艾滋病毒风险的艾滋病毒阴性年轻男性中收集数据。收集了关于社会人口学特征、性风险行为以及对PrEP的担忧等定量数据。使用Stata 15.0统计软件进行数据分析。计算汇总统计数据，并以表格、频率和比例形式呈现。采用二元逻辑回归进行双变量分析，以确定与PrEP可接受性相关的独立因素。在双变量分析中p < 0.10的所有因素和混杂因素都纳入最终的逻辑回归模型。所有p < 0.05的因素都被认为与主要结局显著相关。
409名受访者的平均年龄为21.8岁（标准差[SD]=1.9）。大多数人（97.8%，n = 393）有未采取保护措施的插入式性行为。PrEP的可接受性较高，因为大多数参与者基于可接受性的六个构成要素接受使用PrEP（93.6%，n = 383）。认为自己有感染艾滋病毒风险的参与者接受PrEP的几率更高（调整后的优势比[aOR]=4.23，95%置信区间[CI]=1.05 - 17.04）。知道其伴侣艾滋病毒感染状况的参与者（aOR=0.25，95%CI = 0.07 - 0.88）、那些觉得从医疗机构索要PrEP会尴尬的参与者（aOR=0.12，95%CI = 0.04 - 0.39）以及那些对使用PrEP有耻辱感的参与者（aOR=0.13，95%CI = 0.04 - 0.41）接受PrEP的几率降低。
我们发现卡格瓦拉渔业社区有感染艾滋病毒风险的年轻男性对PrEP的接受程度较高。改善渔业社区高危年轻男性获得PrEP服务的机会，可能会增加该人群以及类似环境中PrEP的使用率。卫生部需要采用多种方法提供PrEP，如同伴主导模式、药物分发点、提醒 refill的短信、药店和零售药店。
