Awareness and willingness to use HIV oral pre-exposure prophylaxis among people who inject drugs in Dar es Salaam, Tanzania: A cross-sectional survey

Masunga K Iseselo; Edith A M Tarimo; Eric Sandstrom; Asli Kulane

doi:10.1371/journal.pgph.0000776

Awareness and willingness to use HIV oral pre-exposure prophylaxis among people who inject drugs in Dar es Salaam, Tanzania: A cross-sectional survey

PLOS Glob Public Health. 2022 Nov 22;2(11):e0000776. doi: 10.1371/journal.pgph.0000776. eCollection 2022.

Authors

Masunga K Iseselo^{1

2

3}, Edith A M Tarimo², Eric Sandstrom⁴, Asli Kulane³

Affiliations

¹ Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
² Department of Nursing Management, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
³ Department of Global Public Health, Equity and Health Policy Research Group, Karolinska Institutet, Stockholm, Sweden.
⁴ Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.

Abstract

People who inject drugs (PWID) are at increased risk of HIV infection. Pre-exposure prophylaxis (PrEP) could help in HIV prevention among PWIDs. However, little is known about PrEP use among PWIDs in low and middle-income countries. This study reports the awareness of and willingness to use PrEP and the associated factors among PWID in Tanzania. A cross-sectional survey was conducted using respondent-driven sampling (RDS) to recruit PWIDs in Dar es Salaam, Tanzania. Data were collected using an interviewer-administered questionnaire. Chi-square statistical test was used during data analysis. The P-value of < 0.05 was used to ascertain the statistically significant relationship. IBM SPSS Statistics 25.0 was used to analyze the data. The analysis consisted of 260 PWIDs. The mean age of the respondents was 39.0 years with a standard deviation (SD) of ±7.5. Most of the respondents were male (n = 232, 89.2%) with primary education (n = 176, 67.7%). Despite the low awareness of PrEP (n = 42, 165.28%) in the study sample, the majority (n = 239, 91.9%) were willing to use PrEP. Both awareness of and willingness to use PrEP were associated with gender (p = .002 and p = < .001), awareness of HIV prevention programs(p = < .001 and p = .006), selling sex (p = .010 and p = .021), and frequency of condomless sexual intercourse (p = .029 and p = .025) respectively. In multivariable logistic regression, only gender(p = 0.046) was related to awareness of PrEP while awareness of HIV prevention programs (p = 0.009), the risk level of HIV infection(p = < .001), number of sexual partners(p = 0.046), and frequency of condomless sex(p = 0.032) were associated with willingness to use PrEP. Other factors were not statistically significant. Despite low awareness, PWIDs are highly willing to use PrEP. Future research should assess the acceptability of injectable PrEP for PWID, as their acquaintance with injection may make the formulation more practical.

Copyright: © 2022 Iseselo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Grants and funding

The study is funded by Swedish International Development Agency(Sida). The funder has no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.