Oral Pre-Exposure Prophylaxis Accessibility, Knowledge, Barriers, and Facilitators Among Men Who Have Sex With Men in Bulawayo, Zimbabwe

Abstract

Great strides have been made globally toward ending HIV and AIDS as a threat by 2030, although the rate of new HIV infections among men who have sex with men remains very high. Due to their risk of getting HIV and AIDS, utilization of pre-exposure prophylaxis (PrEP) can potentially reduce the risk of HIV transmission among this population. This study sought to analyze the accessibility, knowledge, and potential barriers and facilitators to assessing PrEP by men who have sex with men. The quantitative method was conducted on 65 men who have sex with men through questionnaires loaded on Kobo Collect. Chi-square test, odds ratios, and logistic regression were used to associate different demographic characteristics with knowledge and significance of barriers in PrEP access using STATA 15. A hotspot map of PrEP and locations was created using QGIS. About 84% of respondents accessed pills from friendly facilities. The remaining accessed them from public hospitals, namely Mpilo and United Bulawayo Hospitals. Over 90% of the respondents were found to be highly knowledgeable. Notably, barriers included lack of information, fear of side effects, pills not accessible, pill taste, odor and size, stigma, and lack of protection from other sexually transmitted infections. Facilitators were educated about PrEP, the existence of friendly health facilities, making pills available at all times, partner support, increased number of friendly health facilities and support groups. Maximizing the potential of PrEP as an efficient HIV-prevention intervention among this population requires ongoing efforts to remove barriers and promote facilitators.

Exploring Barriers and Facilitators That Influence Uptake of Oral Pre-Exposure Prophylaxis Among Men Who Have Sex With Men in Bulawayo, Zimbabwe: Key Stakeholder’s Perspectives

“…Having many MSM-friendly facilities means more MSM are going to access PrEP in a non-judgmental environment, offering differentiated and support services, hence improving PrEP use. The study findings concur with other literature sources that reported increasing the number of health care facilities and offering PrEP services as important facilitators ( Harawa et al, 2016 ; Moyo & Nunu, 2023a ). Other scholars reported support organizations or clubs for PrEP users as vital facilitators in improving PrEP utilization ( Graham et al, 2022 ; Harawa et al, 2016 ).…”

“…Furthermore, health service providers in these facilities are trained to provide affirming sexual health services to gender and minority populations, thus ensuring a safe and friendly environment. These findings align with other authors who reported that having MSM-friendly facilities is important in the uptake and adherence of PrEP and having relatable health care providers is vital in ensuring improved PrEP uptake among this population ( Graham et al, 2022 ; Moyo & Nunu, 2023a ; Pichon et al, 2022 ).…”