Awareness and Willingness to Use Pre-exposure Prophylaxis Among the University of Zambia Students: A Cross-sectional Study

Overview

Journal Health Sci Rep

Specialty General Medicine

Date 2024 Sep 11

PMID 39257911

Authors

Martin Kampamba

Natalia N Nelumbu

Christabel N Hikaambo

Steward Mudenda

Jimmy M Hangoma

Mwape Kunda

Webrod Mufwambi

Audrey Hamachila

Moses Mukosha

Affiliations

Soon will be listed here.

Abstract

Background And Aims: Despite a quick rollout of PrEP as a preventive method against Human Immunodeficiency Virus (HIV) infections in Zambia, adolescent and young adult populations have remained very vulnerable to HIV infection. This study assessed the awareness and willingness to use PrEP among University of Zambia (UNZA) students.

Methods: Three hundred forty-six students participated in this cross-sectional study at UNZA between March and June 2021. A previously validated questionnaire assessed willingness to use PrEP. We tested the hypothesized pathways between sexual risk behavior and willingness to use PrEP using the structural equation model Multivariate logistic regression analysis was employed to determine factors associated with willingness to use PrEP. Variables with a -value < 0.05 were considered statistically significant.

Results: Of the 346 students, 271 (78.3%) were aware of PrEP, and 59 (17.1%) of the participants were willing to use PrEP. Only 17 (4.9%) of the participants had used PrEP before In the multivariable logistic regression model, students who were aware of PrEP compared to those who were not (AOR = 3.03, 95% CI: 1.10, 8.40, p) were more likely to be willing to use PrEP. Sexual risk behavior indirectly and positively affected willingness to use PrEP through awareness of PrEP.

Conclusion: Even though most students were aware of PrEP, the willingness to use this preventative measure is still low among UNZA students, resulting in low uptake. Therefore, concerted efforts are required to influence the willingness and uptake of PrEP, especially in high-risk age groups such as university students

Citing Articles

Pre‑exposure Prophylaxis Awareness and Endorsement among Adolescents and Young Adults in Tanzania: Insights from the 2022 Demographic and Health Survey.

Kapola A, Musoke R, Manayon G, Fussi H, Bakari H, Ally H Ann Glob Health. 2025; 91(1):4.

PMID: 39896105 PMC: 11784521. DOI: 10.5334/aogh.4589.

References

Donnell D, Baeten J, Bumpus N, Brantley J, Bangsberg D, Haberer J . HIV protective efficacy and correlates of tenofovir blood concentrations in a clinical trial of PrEP for HIV prevention. J Acquir Immune Defic Syndr. 2014; 66(3):340-8. PMC: 4059553. DOI: 10.1097/QAI.0000000000000172. View

Stelzle D, Godfrey-Faussett P, Jia C, Amiesimaka O, Mahy M, Castor D . Estimating HIV pre-exposure prophylaxis need and impact in Malawi, Mozambique and Zambia: A geospatial and risk-based analysis. PLoS Med. 2021; 18(1):e1003482. PMC: 7799816. DOI: 10.1371/journal.pmed.1003482. View

Okeke N, McLaurin T, Gilliam-Phillips R, Wagner D, Barnwell V, Johnson Y . Awareness and acceptability of HIV pre-exposure prophylaxis (PrEP) among students at two historically Black universities (HBCU): a cross-sectional survey. BMC Public Health. 2021; 21(1):943. PMC: 8132367. DOI: 10.1186/s12889-021-10996-2. View

Jaspal R, Nerlich B . Polarised press reporting about HIV prevention: Social representations of pre-exposure prophylaxis in the UK press. Health (London). 2016; 21(5):478-497. DOI: 10.1177/1363459316649763. View

Ajayi A, Ismail K, Adeniyi O, Akpan W . Awareness and use of pre-exposure and postexposure prophylaxes among Nigerian university students: Findings from a cross-sectional survey. Medicine (Baltimore). 2018; 97(36):e12226. PMC: 6133481. DOI: 10.1097/MD.0000000000012226. View

Solomon H, Moraes A, Williams D, Fotso A, Duong Y, Ndongmo C . Prevalence and correlates of active syphilis and HIV co-Infection among sexually active persons aged 15-59 years in Zambia: Results from the Zambia Population-based HIV Impact Assessment (ZAMPHIA) 2016. PLoS One. 2020; 15(7):e0236501. PMC: 7380641. DOI: 10.1371/journal.pone.0236501. View

McCormack S, Dunn D, Desai M, Dolling D, Gafos M, Gilson R . Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet. 2015; 387(10013):53-60. PMC: 4700047. DOI: 10.1016/S0140-6736(15)00056-2. View

Marks S, Merchant R, Clark M, Liu T, Rosenberger J, Bauermeister J . Potential Healthcare Insurance and Provider Barriers to Pre-Exposure Prophylaxis Utilization Among Young Men Who Have Sex with Men. AIDS Patient Care STDS. 2017; 31(11):470-478. PMC: 5665093. DOI: 10.1089/apc.2017.0171. View

Lavoie M, Blanco N, Mwango L, Nichols B, Whittington A, Lindsay B . Addressing the Need for a Preexposure Prophylaxis Monitoring and Evaluation Implementation Guide: Experience From Zambia. Glob Health Sci Pract. 2023; 11(2). PMC: 10141438. DOI: 10.9745/GHSP-D-22-00396. View

10.

Xie L, Wu Y, Meng S, Hou J, Fu R, Zheng H . Risk Behavior Not Associated with Self-Perception of PrEP Candidacy: Implications for Designing PrEP Services. AIDS Behav. 2019; 23(10):2784-2794. PMC: 7232689. DOI: 10.1007/s10461-019-02587-5. View

11.

Fonner V, Dalglish S, Kennedy C, Baggaley R, OReilly K, Koechlin F . Effectiveness and safety of oral HIV preexposure prophylaxis for all populations. AIDS. 2016; 30(12):1973-83. PMC: 4949005. DOI: 10.1097/QAD.0000000000001145. View

12.

Bond K, Gunn A . Perceived Advantages and Disadvantages of Using Pre-Exposure Prophylaxis (PrEP) among Sexually Active Black Women: An Exploratory Study. J Black Sex Relatsh. 2017; 3(1):1-24. PMC: 5512598. DOI: 10.1353/bsr.2016.0019. View

13.

Marrazzo J, Ramjee G, Richardson B, Gomez K, Mgodi N, Nair G . Tenofovir-based preexposure prophylaxis for HIV infection among African women. N Engl J Med. 2015; 372(6):509-18. PMC: 4341965. DOI: 10.1056/NEJMoa1402269. View

14.

Bunting S, Garber S, Goldstein R, Ritchie T, Batteson T, Keyes T . Student Education About Pre-exposure Prophylaxis (PrEP) Varies Between Regions of the United States. J Gen Intern Med. 2020; 35(10):2873-2881. PMC: 7573046. DOI: 10.1007/s11606-020-05736-y. View

15.

Dwyer-Lindgren L, Cork M, Sligar A, Steuben K, Wilson K, Provost N . Mapping HIV prevalence in sub-Saharan Africa between 2000 and 2017. Nature. 2019; 570(7760):189-193. PMC: 6601349. DOI: 10.1038/s41586-019-1200-9. View

16.

Wilton J, Senn H, Sharma M, Tan D . Pre-exposure prophylaxis for sexually-acquired HIV risk management: a review. HIV AIDS (Auckl). 2015; 7:125-36. PMC: 4422285. DOI: 10.2147/HIV.S50025. View

17.

Goedel W, Halkitis P, Greene R, Duncan D . Correlates of Awareness of and Willingness to Use Pre-exposure Prophylaxis (PrEP) in Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Geosocial-Networking Smartphone Applications in New York City. AIDS Behav. 2016; 20(7):1435-42. DOI: 10.1007/s10461-016-1353-6. View

18.

Khawcharoenporn T, Chunloy K, Apisarnthanarak A . HIV knowledge, risk perception and pre-exposure prophylaxis interest among Thai university students. Int J STD AIDS. 2014; 26(14):1007-16. DOI: 10.1177/0956462414564607. View

19.

Stover J, Glaubius R, Kassanjee R, Dugdale C . Updates to the Spectrum/AIM model for the UNAIDS 2020 HIV estimates. J Int AIDS Soc. 2021; 24 Suppl 5:e25778. PMC: 8454674. DOI: 10.1002/jia2.25778. View

20.

Were D, Musau A, Atkins K, Shrestha P, Reed J, Curran K . Health system adaptations and considerations to facilitate optimal oral pre-exposure prophylaxis scale-up in sub-Saharan Africa. Lancet HIV. 2021; 8(8):e511-e520. PMC: 9248012. DOI: 10.1016/S2352-3018(21)00129-6. View