ArticleJournal of the International AIDS Society2022
Engagement in the pre-exposure prophylaxis (PrEP) cascade among a respondent-driven sample of sexually active men who have sex with men and transgender women during early PrEP implementation in Zimbabwe.
Article in Journal of the International AIDS Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 19 citations in OpenAlex.
- Urine tenofovir testing for real-time PrEP adherence feedback: a qualitative study involving transgender women in Uganda.Journal of the International AIDS Society · 2024Trial
- Awareness, willingness, and uptake of pre-exposure prophylaxis (PrEP) among men who have sex with men in Ghana.BMC infectious diseases · 2025Article
- Knowledge and Awareness of Pre-Exposure Prophylaxis Among Men in Sub-Saharan Africa: A Scoping Review Protocol.Health science reports · 2025Article
- PrEP in the key population community: A qualitative study of perspectives on pre-exposure prophylaxis by gay, bisexual and other men who have sex with men and female sex workers in Kigali, Rwanda.PLOS global public health · 2025Article
- Willingness to pay and price elasticity of demand for long-acting injectable cabotegravir among men who have sex with men in Guangxi, China.Frontiers in pharmacology · 2024Article
- Healthcare access and barriers to utilization among transgender and gender diverse people in Africa: a systematic review.BMC global and public health · 2024Review
- Loss to Follow-Up from HIV Pre-Exposure Prophylaxis Care in Men Who Have Sex with Men in West Africa.Viruses · 2022Article
- Socio-behavioral correlates of pre-exposure prophylaxis use and correct adherence in men who have sex with men in West Africa.BMC public health · 2022Article
- Substance Use and Healthcare Utilization Across the Pre-Exposure Prophylaxis (PrEP) Care Cascade among Black and Latino Men Who Have Sex with Men.Substance use & misuse · 2022Article
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Authors and funding
11 authors at 5 institutions in 3 countries.
Funding
Abstract
introductionZimbabwe is scaling up pre-exposure prophylaxis (PrEP) for key populations, including men who have sex with men (MSM) and transgender women (TGW). To assess implementation and inform HIV programming, we evaluated gaps in PrEP awareness, uptake and use, and correlates of awareness and uptake among a sample of MSM, TGW and genderqueer individuals (GQ) in Harare and Bulawayo, Zimbabwe.
methodsRespondent-driven sampling was used to recruit 1194 MSM and 344 TGW/GQ aged ≥18 to participate in a cross-sectional survey assessing HIV-related outcomes in 2019. Consenting participants completed a questionnaire on socio-demographic information, sexual risk practices and engagement in HIV services and underwent HIV testing. Descriptive statistics were used to assess the PrEP cascade. Multiple logistic regression models were used to identify factors associated with PrEP awareness and uptake among HIV-negative participants. Data were unweighted as the sample did not reach convergence on key estimates.
resultsAmong the 1167 HIV-negative participants, most (79.2%) were MSM compared to TGW/GQ (20.8%). Median age was 24 years. Overall, 45.8% were aware of PrEP and of those, 31.3% had ever taken PrEP. Most (71.1%) reporting never taking PrEP were willing to start PrEP; the main reasons for never starting PrEP included not knowing where to access it (24.8%) and fearing side effects (20.4%). Among those who had ever taken PrEP, 74.9% had taken PrEP in the last 6 months; of these, 42.4% had taken PrEP the day of or day preceding the survey. Side effects represented the most common (59.5%) reason for discontinuing PrEP. MSM (adjusted odds ratio [aOR]: 2.5, 95% confidence interval [CI]: 1.8-3.6) and TGW/GQ in Harare (aOR: 3.1, 95% CI: 2.1-4.7), and TGW/GQ in Bulawayo (aOR: 2.4, 95% CI: 1.1-5.3) had higher awareness of PrEP than MSM in Bulawayo. Overall, TGW/GQ were more likely to have ever taken PrEP compared to MSM (aOR: 1.6, 95% CI: 1.01-2.4).
conclusionsFindings emphasize the need for tailored interventions to promote PrEP among key populations. As HIV programs in Zimbabwe continue to expand PrEP services, these data, including barriers to starting and continuing PrEP, can inform strategies to address gaps along the PrEP cascade.
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