Speakers
Description
Background:
HIV Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention strategy, especially for individuals at heightened risk. In 2016, Zambia launched PrEP as a major HIV prevention strategy and set up a National PrEP Task Force to oversee the creation and promotion of policy. Despite enacting the policy, its uptake remains limited, particularly among women seeking abortion services. This study was aimed to assess awareness and willingness to use PrEP and identify associated factors the use of PrEP among women seeking abortion services in Kafue, Zambia.
Methods:
An institutional-based cross-sectional study was conducted from October to December 2024 among women seeking abortion care services recruited systematically randomly as they were accessing care at public hospital in Kafue, Zambia. Data was collected using an interviewer-administered structured, and pretested questionnaire. Awareness and willingness consisted of dichotomous responses (yes or no) whether women were aware or willing to use PrEP respectively. Multiple regression model was used to assess factors associated with awareness and willingness to use PrEP among women seeking abortion care services.
Results:
A total of 250 respondents participated in this study. Results showed that 76.0% (n = 190) of participants were aware of PrEP, and 71.2% (n = 178) expressed willingness to use it. However, actual utilization was low, with only 18.0% (n = 45) having ever used PrEP. Prior awareness was a strong predictor of willingness (OR = 5.232, 95% CI: 2.139–12.799). 72.7% of Married individuals, 74.6% of Protestants and 61.8% participants who were unsure of their partner’s HIV status were less likely to be willing to use PrEP. (OR = 0.273, 95% CI: 0.099 0.752), (OR = 0.254, 95% CI: 0.066–0.982, p = 0.047) and (OR = 0.382, 95% CI: 0.146–0.997) respectively. However, a recent history of sexually transmitted infections increased willingness (OR = 3.444, 95% CI: 1.028–11.545,). Concerning HIV risk behaviors, 94.4% (n = 236) reported unprotected sex in the past six months, and 39.2% (n = 98) had not undergone HIV testing in the last year. While overall perceived stigma toward PrEP use was low at 8.4% (n = 21), social stigma from friends and family (12.4%, n = 31) and provider-related discrimination (5.6%, n = 14) were still reported. However, perceived stigma was not significantly associated with willingness to use PrEP (χ² = 1.4643, p = 0.481).
Conclusion:
In conclusion, the study demonstrates a high level of PrEP awareness and willingness, but low actual use, among a population exhibiting elevated HIV risk behaviors. Key predictors of willingness to use PrEP include prior awareness, marital status, religious denomination, STI history, and partner HIV status. Although stigma was not statistically significant, its presence underscores the need for stigma-sensitive approaches. Integrating PrEP education, STI screening, and couple-based HIV testing into abortion care services can enhance prevention efforts for this vulnerable group.
Keywords: Pre-Exposure Prophylaxis (PrEP), HIV Prevention, Awareness, Willingness, Risk Behaviors, Perceived Stigma, Abortion Services, Logistic Regression, Kafue General Hospital, Zambia.
