Early PrEP uptake in Africa study gives support for possibility of wider acceptance

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Nearly a fifth of adults whose risk for HIV infection made them eligible for free PrEP — medicine to protect them from the virus — took the opportunity to start taking the drug within 30 days — the majority of them on the day it was offered, a study examining the impacts of health interventions across communities two East African countries found.

The findings point to the possibility, with caveats, that widespread roll out of the proven HIV prevention measure to individuals at high risks for infection across resource-limited communities is feasible, authors of a report on the study write.

Their report, Early Adopters of HIV Preexposure Prophylaxis in a Population-based Combination Prevention Study in Rural Kenya and Uganda was published this week in Clinical Infectious Diseases. The study, in which researchers analyzed factors increasing the likelihood of PrEP acceptance among people in two countries with high HIV prevalence who had either described situations that increased their risks of infection, or who considered themselves at high risk of infection, took place in the context of the SEARCH — Sustainable East Africa Research in Community Health — Study.

Researchers found that people who considered themselves at higher risk were more likely to immediately accept PrEP than people who researchers determined were at higher risk based on answers to questions about their number of concurrent partners, condom use, circumcision, and their knowledge of their partner’s status. Only 35 percent of those deemed by researchers to be at higher risk of infection considered themselves to be at high risk, according to the report. Those who perceived their own risks as high tended to be older, with 42 percent at least 36 years old. People who were tested for HIV and interviewed at community events were also likelier to immediately accept PrEP than people who were tested and interviewed at their homes.

The findings indicate that additional strategies are needed to educate people, particularly younger adults, about their HIV risks and the benefits of PrEP, and to increase access to PrEP for people who test at home, the authors write.

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