Factors Associated with Awareness and Utilization of Pre-Exposure Prophylaxis (PrEP) among Pregnant Women Attending Antenatal Care in Selected Public Hospitals in Lusaka, Zambia
Abstract
Background: Pregnant women are at high risk for HIV infection. Although pre-exposure prophylaxis (PrEP) has been shown to be safe and effective in preventing HIV among risk populations, awareness and utilization of PrEP among pregnant women, remain low in Zambia. This study aimed to assess factors associated with awareness and utilization of PrEP among pregnant women in selected public hospitals in Lusaka City, Zambia.
Methods and Materials: A cross-sectional study was conducted and systematic random sampling was used to select HIV-negative participants from four randomly selected hospitals in Lusaka Zambia. A validated questionnaire was used to collect data on demographic characteristics, awareness, and utilization of PrEP. Chi-square and Mann-Whitney tests were used to assess association between categorical variables Logistic regression analysis was used to identify factors associated with awareness and utilization of PrEP. Data was analyzed using Stata version 15 and for all statistical analysis, a p-value of <0.05 was considered significant.
Results: Among the 377 pregnant women included, almost half 187 (48.8%) were between 21 – 30 years, and only 10(2.6%) were 41 or more years old. There were 53.1% (n=200) who were aware and 12.2% (n=46) were utilizing PrEP. In multivariable analysis, not knowing health facilities that offer PrEP (AOR = 2.88; 95% CI: 1.05 – 10.83; p = 0.023), not knowing eligibility for PrEP (AOR = 4.12; 95% CI: 2.08 – 12.02; p=0.004) and not knowing importance of PrEP (AOR = 6.05; 95% CI: 2.14 – 9.88) were significantly associated with decreased utilization of PrEP. For awareness, those who knew importance of PrEP (AOR = 7.06; 95% CI: 2.09 – 12.8; p=0.002), eligibility criteria (AOR = 2.52; 95% CI: 1.15 – 5.53; p = 0.017) and knowing facilities that offer PrEP (AOR = 6.98, 95% CI: 3.12 – 10.66; p<0.0001) were more likely to be aware of PrEP.
Conclusions: Awareness was low (53.1%) as well as utilization (12.2%) of PrEP. The factors associated with awareness were knowing the facilities that offer PrEP, eligibility, and importance of PrEP. Non-utilisation of PrEP was associated with not knowing the importance, the correct source, eligibility criteria as well as not knowing whether pregnant women can take PrEP.
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