Factors Influencing Willingness to Use Pre-Exposure Prophylaxis among Male Homosexuals at the Sex Workers Outreach Program Clinic

Abstract

The use of antiretroviral agents in an HIV negative person before engaging in coitus with a HIV-positive partner is termed as pre-exposure prophylaxis. The objective of this study was to assess the factors influencing acceptance and willingness to use of pre exposure prophylaxis as a prevention strategy in a group of men who have sex with men. This study sought to examine the participant’s knowledge on HIV transmission, explore the attitudes and behaviors related to HIV among Male Homosexuals, assess the awareness on the methods of preventing HIVAIDS in MSM and finally explore the stigma faced by MSM at the SWOP CITY clinic. This was a cross sectional study that focused on the factors influencing acceptance and willingness of using pre exposure prophylaxis as a HIV prevention method among HIV negative individuals in homosexual relations at Sex workers outreach program clinic, a sample size of 196 individuals was used out of the 386 active HIV negative MSM enrolled at the clinic as per end of July2017, data collection was carried out in August 2017 where Standardized questionnaires were used to collect data from the MSM in SWOP CITY until the sample size for the study was reached. Three focus group discussions were utilized to collect qualitative data on the factors influencing acceptance and willingness to use pre exposure prophylaxis from the selected individuals, collected data was entered, cleaned and exported into SPSS Version 20.0 for analysis, and the data generated was presented in form of tables, pie charts and bar graphs. Only a third were married (opposite sex). Half of the respondents were self-employed. Among those employed, majority [87, 64%] earned from 10,000 to 30000. All of the respondents were aware of HIV AIDs and the majority of the MSM were of the view that transmission was through sexual contact. Less than half indicated that Syphilis was also transmitted through sex compared to a quarter who indicated gonorrhea as also being transmitted sexually, a third just indicated generally STIs with no specific infection in mind. Most of the respondents agreed that the presence of sexually transmitted diseases increased the likelihood of acquiring HIV/AIDS [p value <0.05]. use of condoms, knowing people’s HIV status and sero sorting was found to be most effective methods of preventing the HIV infection [p value <0.05].it was found out that Taking an oral medicine daily to protect oneself from getting infected was to most effective. The qualitative data concurred with the quantitative data as it affirmed that condoms were easily accessible and easy to use, MSM were prone to engage in risky sexual behaviors, stigma was still a major threat in MSM and that they knew about PrEP and the benefits of this intervention. In conclusion PrEP being a newer intervention and recently rolled out, interventions that will address stigma and the risky sexual behaviors that MSM engage in needs to be addressed so that PrEP uptake can be optimized as this will translate to reduction in the HIV/AIDS prevalence in MSM.