Awareness and willingness to use HIV oral pre-exposure prophylaxis among people who inject drugs in Dar es Salaam, Tanzania: A cross-sectional survey

Abstract

People who inject drugs (PWID) are at increased risk of HIV infection. Pre-exposure prophylaxis (PrEP) could help in HIV prevention among PWIDs. However, little is known about PrEP use among PWIDs in low and middle-income countries. This study reports the awareness of and willingness to use PrEP and the associated factors among PWID in Tanzania. A cross-sectional survey was conducted using respondent-driven sampling (RDS) to recruit PWIDs in Dar es Salaam, Tanzania. Data were collected using an interviewer-administered questionnaire. Chi-square statistical test was used during data analysis. The P-value of < 0.05 was used to ascertain the statistically significant relationship. IBM SPSS Statistics 25.0 was used to analyze the data. The analysis consisted of 260 PWIDs. The mean age of the respondents was 39.0 years with a standard deviation (SD) of ±7.5. Most of the respondents were male (n = 232, 89.2%) with primary education (n = 176, 67.7%). Despite the low awareness of PrEP (n = 42, 165.28%) in the study sample, the majority (n = 239, 91.9%) were willing to use PrEP. Both awareness of and willingness to use PrEP were associated with gender (p = .002 and p = < .001), awareness of HIV prevention programs(p = < .001 and p = .006), selling sex (p = .010 and p = .021), and frequency of condomless sexual intercourse (p = .029 and p = .025) respectively. In multivariable logistic regression, only gender(p = 0.046) was related to awareness of PrEP while awareness of HIV prevention programs (p = 0.009), the risk level of HIV infection(p = < .001), number of sexual partners(p = 0.046), and frequency of condomless sex(p = 0.032) were associated with willingness to use PrEP. Other factors were not statistically significant. Despite low awareness, PWIDs are highly willing to use PrEP. Future research should assess the acceptability of injectable PrEP for PWID, as their acquaintance with injection may make the formulation more practical.

The use of oral HIV pre-exposure prophylaxis among people who inject drugs: barriers, and recommendations

“…Integrating oral PrEP services into other services may be cost-effective, considering that some of the infrastructure will already be in place. Furthermore, fewer HCWs may be required compared to when the services are offered separately ( 8 ). In addition, providing oral PrEP in a range of routine settings may help reduce the stigma associated with specialized clinics and HIV services ( 26 ).…”

“…A study conducted in Tanzania revealed that 71.4% of the participants were willing to use oral PrEP if it was made available to them ( 8 ). Factors that were associated with the willingness to use oral PrEP in the study were the risk of HIV infection, the frequency of condomless sex, the number of sexual partners, and being in an HIV prevention program ( 8 ). Another study conducted in India revealed a 52.4% willingness to use oral PrEP among participants ( 9 ).…”

“…Several studies have revealed that PrEP is acceptable among PWID (8)(9)(10)(11). A study conducted in Tanzania revealed that 71.4% of the participants were willing to use oral PrEP if it was made available to them (8).…”

“…Several studies have revealed that PrEP is acceptable among PWID (8)(9)(10)(11). A study conducted in Tanzania revealed that 71.4% of the participants were willing to use oral PrEP if it was made available to them (8). Factors that were associated with the willingness to use oral PrEP in the study were the risk of HIV infection, the frequency of condomless sex, the number of sexual partners, and being in an HIV prevention program (8).…”