Abstract：
The World Health Organization (WHO) recommends the use of pre-exposure prophylaxis (PrEP) in key populations at elevated risk for exposure to HIV. If used effectively, PrEP can reduce annual HIV incidence to below 0.05%. However, PrEP is not acceptable among all communities that might benefit from it. There is, therefore, a need to understand perceptions of PrEP and factors associated with willingness to use PrEP among key populations at risk of HIV, such as members of communities with exceptionally high HIV prevalence.
To examine the perceptions and factors associated with willingness to use oral PrEP among members of fishing communities in Uganda, a key population at risk of HIV.
We conducted an explanatory sequential mixed-methods study at Ggaba fishing community from February to June 2019. Survey data were collected from a systematic random sample of 283 community members in which PrEP had not been rolled out yet by the time of we conducted the study. We carried out bivariate tests of association of willingness to use PrEP with demographic characteristics, HIV risk perception, HIV testing history. We estimated prevalence ratios for willingness to use PrEP. We used backward elimination to build a multivariable modified Poisson regression model to describe factors associated with willingness to use PrEP. We purposively selected 16 participants for focus group discussions to contextualize survey findings, analysing data inductively and identifying emergent themes related to perceptions of PrEP.
We enrolled 283 participants with a mean age of 31 ± 8 years. Most (80.9%) were male. The majority of participants had tested for HIV in their lifetime, but 64% had not tested in the past 6 months. Self-reported HIV prevalence was 6.4%. Most (80.6, 95%CI 75.5-85.0) were willing in principle to use PrEP. Willingness to use PrEP was associated with perceiving oneself to be at high risk of HIV (aPR 1.99, 95%CI 1.31-3.02, P = 0.001), having tested for HIV in the past 6-months (aPR 1.13, 95%CI 1.03-1.24, P = 0.007), and completion of tertiary education (aPR 1.97, 95%CI 1.39-2.81, P < 0.001). In focus group discussions, participants described pill burden, side-effects and drug safety as potential barriers to PrEP use.
Oral PrEP was widely acceptable among members of fishing communities in peri-urban Kampala. Programs for scaling-up PrEP for fisherfolk should merge HIV testing services with sensitization about PrEP and also increase means of awareness of PrEP as an HIV preventive strategy .
To examine the perceptions and factors associated with willingness to use oral PrEP among members of fishing communities in Uganda, a key population at risk of HIV.
We conducted an explanatory sequential mixed-methods study at Ggaba fishing community from February to June 2019. Survey data were collected from a systematic random sample of 283 community members in which PrEP had not been rolled out yet by the time of we conducted the study. We carried out bivariate tests of association of willingness to use PrEP with demographic characteristics, HIV risk perception, HIV testing history. We estimated prevalence ratios for willingness to use PrEP. We used backward elimination to build a multivariable modified Poisson regression model to describe factors associated with willingness to use PrEP. We purposively selected 16 participants for focus group discussions to contextualize survey findings, analysing data inductively and identifying emergent themes related to perceptions of PrEP.
We enrolled 283 participants with a mean age of 31 ± 8 years. Most (80.9%) were male. The majority of participants had tested for HIV in their lifetime, but 64% had not tested in the past 6 months. Self-reported HIV prevalence was 6.4%. Most (80.6, 95%CI 75.5-85.0) were willing in principle to use PrEP. Willingness to use PrEP was associated with perceiving oneself to be at high risk of HIV (aPR 1.99, 95%CI 1.31-3.02, P = 0.001), having tested for HIV in the past 6-months (aPR 1.13, 95%CI 1.03-1.24, P = 0.007), and completion of tertiary education (aPR 1.97, 95%CI 1.39-2.81, P < 0.001). In focus group discussions, participants described pill burden, side-effects and drug safety as potential barriers to PrEP use.
Oral PrEP was widely acceptable among members of fishing communities in peri-urban Kampala. Programs for scaling-up PrEP for fisherfolk should merge HIV testing services with sensitization about PrEP and also increase means of awareness of PrEP as an HIV preventive strategy .
摘要：
世界卫生组织（WHO）建议在暴露于艾滋病毒风险较高的关键人群中使用暴露前预防（PrEP）。如果使用有效，PrEP可以将每年的HIV发病率降低到0.05％以下。然而,PrEP在所有可能从中受益的社区中是不可接受的。有,因此,需要了解对PrEP的看法以及与在有艾滋病毒风险的关键人群中使用PrEP的意愿相关的因素，例如艾滋病毒感染率极高的社区成员。
为了研究乌干达渔业社区成员中与使用口头PrEP的意愿相关的看法和因素，有感染艾滋病毒风险的关键人群。
我们于2019年2月至6月在Ggaba捕鱼社区进行了解释性序贯混合方法研究。调查数据是从283个社区成员的系统随机样本中收集的，在我们进行研究时，PrEP尚未推出。我们对使用PrEP的意愿与人口统计特征的关联进行了双变量测试，艾滋病毒风险感知，HIV检测史我们估计了使用PrEP的意愿的患病率比率。我们使用后向消除法建立多变量修正的Poisson回归模型来描述与使用PrEP的意愿相关的因素。我们有目的地选择了16名参与者进行焦点小组讨论，以了解调查结果的背景，归纳分析数据并确定与PrEP感知相关的紧急主题。
我们招募了283名参与者，平均年龄为31±8岁。大多数（80.9%）为男性。大多数参与者在他们的一生中都进行了艾滋病毒检测，但64%的人在过去6个月没有进行过测试.自我报告的艾滋病毒感染率为6.4%。大多数（80.6，95CI75.5-85.0）原则上愿意使用PrEP。使用PrEP的意愿与认为自己处于HIV的高风险相关（aPR1.99，95CI1.31-3.02，P=0.001），在过去的6个月中进行了HIV检测（APR1.13，95CI1.03-1.24，P=0.007），并完成高等教育（APR1.97，95CI1.39-2.81，P<0.001）。在焦点小组讨论中，参与者描述了药丸负担，副作用和药物安全性是使用PrEP的潜在障碍。
在坎帕拉市郊的捕鱼社区成员中，OralPrEP被广泛接受。为渔民扩大PrEP的计划应将HIV检测服务与对PrEP的敏感性结合起来，并提高对PrEP作为HIV预防策略的认识。
为了研究乌干达渔业社区成员中与使用口头PrEP的意愿相关的看法和因素，有感染艾滋病毒风险的关键人群。
我们于2019年2月至6月在Ggaba捕鱼社区进行了解释性序贯混合方法研究。调查数据是从283个社区成员的系统随机样本中收集的，在我们进行研究时，PrEP尚未推出。我们对使用PrEP的意愿与人口统计特征的关联进行了双变量测试，艾滋病毒风险感知，HIV检测史我们估计了使用PrEP的意愿的患病率比率。我们使用后向消除法建立多变量修正的Poisson回归模型来描述与使用PrEP的意愿相关的因素。我们有目的地选择了16名参与者进行焦点小组讨论，以了解调查结果的背景，归纳分析数据并确定与PrEP感知相关的紧急主题。
我们招募了283名参与者，平均年龄为31±8岁。大多数（80.9%）为男性。大多数参与者在他们的一生中都进行了艾滋病毒检测，但64%的人在过去6个月没有进行过测试.自我报告的艾滋病毒感染率为6.4%。大多数（80.6，95CI75.5-85.0）原则上愿意使用PrEP。使用PrEP的意愿与认为自己处于HIV的高风险相关（aPR1.99，95CI1.31-3.02，P=0.001），在过去的6个月中进行了HIV检测（APR1.13，95CI1.03-1.24，P=0.007），并完成高等教育（APR1.97，95CI1.39-2.81，P<0.001）。在焦点小组讨论中，参与者描述了药丸负担，副作用和药物安全性是使用PrEP的潜在障碍。
在坎帕拉市郊的捕鱼社区成员中，OralPrEP被广泛接受。为渔民扩大PrEP的计划应将HIV检测服务与对PrEP的敏感性结合起来，并提高对PrEP作为HIV预防策略的认识。
