Awareness and Openness to the Use of PrEP Among a Nationally Representative Sample of South African Adults

Overview

Journal Pan Afr Med J

Date 2024 Nov 4

PMID 39492852

Authors

Lungile Nkosi

Queen Dooshima Mmem

Tina Ngufan Tsafa

Joy Ngodoo Gwar

Israel Terungwa Agaku

Affiliations

Soon will be listed here.

Abstract

Introduction: 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.

Methods: 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.

Results: 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%).

Conclusion: 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).

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