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- Title
Qualitative Assessment of Barriers and Facilitators of PrEP Use Before and After Rollout of a PrEP Program for Priority Populations in South-central Uganda.
- Authors
Ddaaki, William; Strömdahl, Susanne; Yeh, Ping Teresa; Rosen, Joseph G.; Jackson, Jade; Nakyanjo, Neema; Kagaayi, Joseph; Kigozi, Godfrey; Nakigozi, Gertrude; Grabowski, M. Kathryn; Chang, Larry W.; Reynolds, Steven J.; Nalugoda, Fred; Ekström, Anna Mia; Kennedy, Caitlin E.
- 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 in-depth 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.
- Subjects
UGANDA; HIV prevention; HIV infection risk factors; EVALUATION of human services programs; FOCUS groups; SOCIAL support; ATTITUDE (Psychology); RESEARCH methodology; MEDICAL personnel; INTERVIEWING; SEX work; SOCIAL stigma; HUMAN services programs; EXPERIENCE; FISHING; HEALTH literacy; OCCUPATIONS; NATIONAL health services; HEALTH behavior; INDEPENDENT living; DESCRIPTIVE statistics; PREVENTIVE medicine; THEMATIC analysis
- Publication
AIDS & Behavior, 2021, Vol 25, Issue 11, p3547
- ISSN
1090-7165
- Publication type
Article
- DOI
10.1007/s10461-021-03360-3