In 2016, almost two million people were infected with HIV worldwide. Additionally, one million deaths globally were related to AIDS. In Rwanda, an estimated three percent of the adult general population is infected with HIV but challenges exist in the utilization of pre-exposure prophylaxis (PrEP) to prevent new infections, a new Yale School of Medicine study found. PrEP is a medication used to prevent high-risk individuals from contracting HIV from their partners.
A random survey of health care workers and community members found that multiple barriers exist among this population in the use of PrEP. Surveys between health care workers and community members varied slightly. Both surveys asked about knowledge and perception of HIV, preexisting knowledge of PrEP, and attitudes towards PrEP. In addition, health care workers were asked about their interest in providing PrEP. Community members were also asked about their knowledge and perceptions of the cause and transmission of HIV. The surveys also collected demographic information.
The study revealed that there are still misconceptions about HIV throughout the community with some participants believing that HIV was due to a punishment from God, cigarette smoking, or alcohol consumption. Within both groups, over 50 percent of respondents had insufficient knowledge of PrEP but expressed interest in the treatment when it was explained to them. Health care workers responded that promotion of safe sex practices, HIV testing, and treatment would work better than PrEP to decrease infections.
“This is one of the first papers on PrEP use in Rwanda,” said senior author Onyema Ogbuagu, MD, FACP, associate professor of medicine (infectious diseases) and director of the Yale AIDS Clinical Trials Program. “Studies like these provide an information base for how an intervention like PrEP is perceived and can be used for future implementation efforts.”
Co-authors on the study, published in PLOS ONE, include Immaculate Kambutse, MD, MMed and Grace Igiraneza, MD, MMed, former resident and attending physician respectively at Kigali University Teaching Hospital in Kigali, Rwanda.