Winnie Agwang

Title : Willingness to take Pre-Exposure Prophylaxis (PrEP) among highrisk young men aged 10-24 years in Masese fishing community, Jinja district, Uganda

Abstract:

Background: Globally, Pre-Exposure Prophylaxis (PrEP) is an HIV prevention strategy for high-risk populations including fishing communities. However, some communities have not embraced PrEP. We therefore assessed willingness to take PrEP among high-risk young men and their understanding of PrEP in a fishing community in Uganda.

Methods: We conducted a cross-sectional study, between October and November 2020, using quantitative and qualitative data collection methods among young men aged 10-24 years in Masese fishing community, Eastern Uganda. We surveyed 479 young men, who had two or more sexual partners with inconsistent or no condom use. Participants who reported they would take PrEP when provided were categorized as willing. We also conducted four focus group discussions (n=32) among a purposive sample of young men to explore understanding of PrEP. We conducted multivariable modified Poisson regression for the quantitative and thematic analysis for qualitative data.

Results: Overall, 86.4% (n=414/479) of the participants were willing to take PrEP. Willingness to take PrEP was significantly lower among single/never married participants compared to the married (adjusted Prevalence Ratio(aPR)=0.92;95%CI:0.87,0.98). Willingness to take PrEP was higher among participants who self-perceived to be high-risk for HIV (aPR=1.11;95%CI:1.03,1.20); perceived less PrEP side-effects (aPR=1.56;95%CI:1.55,2.24) and would obtain PrEP within their community (aPR=1.40;95%CI:1.25,1.57). From the discussions, participants described PrEP as a drug used to prevent HIV, but some could not differentiate PrEP from Post-Exposure Prophylaxis and did not know when it was taken. Some participants feared that PrEP would lead to loss of libido while some feared it would increase sexual activity and expose them to other venereal diseases.

Conclusion: There was high willingness to take PrEP among young men in fishing communities. Strategies to improve PrEP interventions may be more effective if they target single men and provision of PrEP within such communities. Health education will also improve understanding of PrEP and promote risk awareness.

Biography:

Winnie is a results-oriented public health and laboratory officer currently working with Baylor college of medicine, children’s foundation, Uganda under the Global health security directorate. Winnie has a Master of public Health from Makerere University, a post graduate diploma in project planning and management and a Bachelors in Biomedical laboratory Technology. She has also pursued short courses in Clinical epidemiology and Improving Global Health: Focusing on Quality and Safety from the University of California, San Francisco and Harvard Global Health Institute, Harvard T.H. Chan School of Public Health respectively. Winnie has been part of the Erasmus student exchange program between Makerere University, Uganda and Nottingham Trent University in the United Kingdom. Over the years, she has worked with a number of institutions- Makerere University joint AIDS Program, Makerere university school of public health, Ministry of Health and Infectious diseases institute training, mentoring and building capacity of staff in work places and strengthening systems, including health facilities on HIV/TB, COVID-19, Ebola, laboratory quality & Biorisk management and disease surveillance. Through this, she has gained experience in clinical diagnosis, research, with focus on qualitative & quantitative research, scientific writing and surveillance.  Her most recent research was carried out on HIV prevention using Pre-Exposure Prophylaxis (PrEP) among high risk adolescent boys and young men supported by faculty at Makerere university school of public and the Makerere Behavioural and social sciences program.

She is a highly motivated, self-driven person, focused team player with good communication and interpersonal skills, has a positive can-do attitude, is willing to learn with the ability to multi-task and work under minimum supervision. She is also a fast learner and can easily adopt to new environments and conditions. Winnie is seeking to advance her career in Global Health Security and her personal objectives are to improve health through timely diagnosis and research, to promote sustainable quality health care services through health systems strengthening and build capacity of health care providers- “Success without successors is not success”.