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Acceptability and Predictors of Uptake of Anti-retroviral Pre-exposure Prophylaxis (PrEP) Among Fishing Communities in Uganda: A Cross-Sectional Discrete Choice Experiment Survey

Abstract

We used a discrete choice experiment to assess the acceptability and potential uptake of HIV pre-exposure prophylaxis (PrEP) among 713 HIV-negative members of fishing communities in Uganda. Participants were asked to choose between oral pill, injection, implant, condoms, vaginal ring (women), and men circumcision. Product attributes were HIV prevention effectiveness, sexually transmitted infection (STI) prevention, contraception, waiting time, and secrecy of use. Data were analysed using mixed multinomial logit and latent class models. HIV prevention effectiveness was viewed as the most important attribute. Both genders preferred oral PrEP. Women least preferred the vaginal ring and men the implant. Condom use was predicted to decrease by one third among men, and not to change amongst women. Oral PrEP and other new prevention technologies are acceptable among fishing communities and may have substantial demand. Future work should explore utility of multiple product technologies that combine contraception with HIV and other STI prevention.

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Funding

This study was funded by the Health Resources & Service Administration U91HA06801B) and University of Washington Center for AIDS Research (CFAR), an NIH funded program (P30 AI027757) which is supported by the following NIH Institutes and Centers (NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA). The International Partnership for Microbicides (IPM) provided dummy vaginal rings for demonstration purposes.

Author information

MOK, DN, SB, AK, contributed to the study design. MOK, MQ, DN, SB developed the study tools, MOK, DN, KK, oversaw implementation of the study. MOK, DN, and KK, and AK oversaw the data collection. MOK, and MQ, did the data analysis. MOK, and MQ, wrote the first draft of the manuscript. All authors contributed to the interpretation of the results and revision of the manuscript for coherence, and intellectual content.

Correspondence to Monica O. Kuteesa.

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The authors have declared that no competing interests exist.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Kuteesa, M.O., Quaife, M., Biraro, S. et al. Acceptability and Predictors of Uptake of Anti-retroviral Pre-exposure Prophylaxis (PrEP) Among Fishing Communities in Uganda: A Cross-Sectional Discrete Choice Experiment Survey. AIDS Behav 23, 2674–2686 (2019). https://doi.org/10.1007/s10461-019-02418-7

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Keywords

  • Fisherfolk
  • HIV prevention
  • Discrete choice experiment
  • Pre-exposure prophylaxis
  • Uganda