Acceptability of pre-exposure prophylaxis and associated factors among HIV-negative young men in Kagwara fishing community- Serere district: a cross-sectional study

BackgroundDespite the potential efficacy of Pre-Exposure Prophylaxis (PrEP) in reducing HIV risk among at-risk populations, PrEP acceptability remains strikingly varied across populations. We assessed PrEP acceptability and associated factors among at-risk HIV-negative young men in Kagwara fishing community, Serere district. MethodsA cross-sectional quantitative study design was used. Data were collected among 409 at-risk HIV-negative young men aged 15-24 years living in Kagwara fishing community, between August and October 2023. Quantitative data were collected on socio-demographic characteristics, sexual-risk behaviors, knowledge, attitudes, and practices regarding PrEP acceptability. PrEP acceptability was defined as the proportion of young men accepting to use PrEP out of those interviewed, based on six constructs adopted from acceptability framework. Data analyzed using Stata version 15.0 statistical software. Summary statistics computed and presented as tables, frequencies and proportions. Bivariate analysis was conducted using penalized logistic regression to identify independent factors associated with PrEP acceptability. All factors that had p<0.10 at the bivariate analysis and suspected confounders were entered into the final logistic regression model. All factors with p<0.05 were significantly associated with the primary outcome. ResultsOf 409 respondents, average age was 21.8(SD=1.9) years. Majority, (97.8%, n=393) had unprotected penetrative sex while 84.6% (n=346) did not know HIV status of their partners. PrEP acceptability was high at 93.6% (n=383) as majority of the participants accepted to use PrEP based on the six constructs of acceptability. At multivariable level, the factors associated with PrEP acceptability were; perceived risk of getting HIV infection, adjusted odds ratio (aOR)(95%CI)=4.23(1.05, 17.04), knowing the partners HIV status, aOR (95%CI) = 0.25 (0.07, 0.88), feeling embarrassed to ask for PrEP from the facility, aOR (95%CI) = 0.12 (0.04, 0.39), and having concern of stigma associated with use of PrEP, aOR = 0.13 (95% CI, 0.04-0.41). ConclusionWe found a high level of PrEP acceptability among at-risk HIV-negative young men in Kagwara fishing community. Improving access to PrEP services among at-risk young men in the fishing communities may increase PrEP uptake in this population and across similar settings.