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Barriers to post exposure prophylaxis use among men who have sex with men in sub-Saharan Africa: An online cross-sectional survey
موانع استفاده از پروفیلاکسی پس از مواجهه در مردانی که در جنوب صحرای آفریقا با مردان رابطه جنسی برقرار می کنند: یک مطالعه مقطعی بصورت آنلاین-2020 Background: Curbing new HIV infections among MSM in SSA remains problematic, due to cultural beliefs, norms
that oppose same-sex acts, and criminalization of same-sex acts. No study focused on barriers to PEP use in SSA
region has been conducted. Our study focused on identifying barriers to Post-Exposure Prophylaxis (PEP) use
among MSM in sub-Saharan Africa (SSA).
Methods: An online cross-sectional survey was sent out to members of 14 Lesbian, Gay, Transgender, Bisexual,
Queer (LGBTQ) associations in SSA, to identify barriers to PEP utilization in MSM. A total of 297 MSM from 22
countries in SSA completed the survey between 8 January 2019 and 23 February 2019. Descriptive statistics
were generated, chi-square and backward stepwise logistic regression analysis were performed to evaluate the
association between the outcome “PEP use” and other variables.
Results: Most of the MSM were aged 18 to 30, and the majority (220, 74.6%) described themselves as gay.
Rwanda had the highest number of respondents (117, 39.7% of the total), followed by Nigeria, Ghana and South-
Africa.
The majority of respondents reported having heard about PEP (234, 80.7%), and the average PEP correct
knowledge level was 59%.
Five characteristics were associated with increased odds of using PEP: Age, having vocational education,
having heard of PEP, knowledge of where to get PEP, and having been refused housing.
Conclusion: There is a need for a collaborative effort between policy makers, key players in HIV prevention, and
MSM associations in SSA to remove barriers to PEP uptake to promote optimal PEP utilization amongst MSM. Keywords: Post-exposure prophylaxis | MSM | Key population | HIV prevention | Sub-Saharan Africa |
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