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Behavioral & Social Science

Category: PrEP - HIV

(P294-LB) Acceptability of and willingness to use HIV pre-exposure prophylaxis in community Pharmacy users in Uganda

Wednesday, July 26, 2023
16:00 – 18:00 CST
Background

HIV pre-exposure prophylaxis (PrEP) is highly effective in reducing HIV incidence. In Uganda, PrEP was rolled out by the Ministry of Health in 2017 for specific persons considered high-risk for HIV acquisition. Community pharmacies (CPs) are non-clinical settings that are often the first point of contact in settings with fragile health facilities. We assessed willingness to use HIV PrEP in CP clients, including among persons seeking sexually transmitted infections (STI) syndromic treatment in Uganda.

Methods

We conducted a prospective cohort study of pharmacy clients purchasing treatment for sexually transmitted infections (STIs) and non-STI-related conditions in 18 CPs in Urban Uganda. Study participants were tested for curable STIs and HIV using point-of-care diagnostics. Curable STI treatment was offered, and linkage-to-care was provided for those diagnosed with HIV. Willingness to use HIV PrEP was assessed through a structured questionnaire. Chi-square tests were used to compare the proportions of factors associated with willingness to take HIV PrEP among pharmacy clients.

Results

Between May 2021 and June 2022, 450 participants CP clients were enrolled in the study, 236 (52.4%) were symptomatic (seeking STI treatment) and 214 (47.6%) were asymptomatic (seeking emergency contraception (n=84) or other non-STI related treatments (n=130). HIV prevalence was 5.8% (26/450). Out of 424 who were either HIV-negative or unaware of their HIV-status, 266 (62.7%) were female; 102 (24.1%) had a curable STI, (Syphilis, gonorrhea, chlamydia, trichomoniasis); 88.9% had a regular sexual partner; and 385 (90.8%) were willing to use PrEP. However, 268 (69.6%) were not aware of PrEP prior to joining the study, of these 156 (58.2%) had low or no STI knowledge; 93/102 (91.2%) with a laboratory-confirmed STI were willing to use PrEP. There were no associations with alcohol or drug use, or involvement in transactional sex by bivariate analysis.

Conclusion

Access to formal health care services remain limited in Uganda; community pharmacies present a potential opportunity to reach persons with STI who may be eligible for PrEP and willing to use it. CP should be leveraged to sensitize users on PrEP and to screen for STIs which, if positive, would allow rapid initiation of PrEP.