Qualitative Assessment of Barriers and Facilitators of PrEP Use Before and After Rollout of a PrEP Program for Priority Populations in South‑central Uganda
Loading...
Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
AIDS and Behavior
Abstract
Uganda piloted HIV pre-exposure prophylaxis (PrEP) for priority populations (sex workers, fishermen, truck drivers, discordant
couples) in 2017. To assess facilitators and barriers to PrEP uptake and adherence, we explored perceptions of PrEP
before and experiences after rollout among community members and providers in south-central Uganda. We conducted 75 indepth
interviews and 12 focus group discussions. We analyzed transcripts using a team-based thematic framework approach.
Partners, family, peers, and experienced PrEP users provided adherence support. Occupational factors hindered adherence
for sex workers and fishermen, particularly related to mobility. Pre-rollout concerns about unskilled/untrained volunteers
distributing PrEP and price-gouging were mitigated. After rollout, awareness of high community HIV risk and trust in PrEP
effectiveness facilitated uptake. PrEP stigma and unexpected migration persisted as barriers. Community-initiated, tailored
communication with successful PrEP users may optimize future engagement by addressing fears and rumors, while flexible
delivery and refill models may facilitate PrEP continuation and adherence.
Description
Keywords
Pre-exposure prophylaxis, Implementation science, Uganda, Sex workers, Fishing communities
Citation
Ddaaki, W., Strömdahl, S., Yeh, P. T., Rosen, J. G., Jackson, J., Nakyanjo, N., ... & Kennedy, C. E. (2021). Qualitative assessment of barriers and facilitators of PrEP use before and after rollout of a PrEP program for priority populations in South-central Uganda. AIDS and Behavior, 25(11), 3547-3562. https://doi.org/10.1007/s10461-021-03360-3