Brief Report: HIV Pre-exposure Prophylaxis Awareness and Use Among Rakai Community Cohort Study Youth Aged 15-24

Area of Science:

• Public Health
• Epidemiology
• HIV Prevention

Background:

• Adolescents and young adults (AYAs) are critical in HIV epidemic control.
• Oral pre-exposure prophylaxis (PrEP) is an effective HIV prevention tool for AYAs in sub-Saharan Africa.
• Limited population-based data exists on PrEP awareness and use among AYAs in this region.

Purpose of the Study:

• To assess PrEP awareness and ever-use among AYAs aged 15-24 in south-central Uganda.
• To identify sociodemographic factors associated with PrEP awareness and use.
• To inform HIV prevention strategies targeting AYAs.

Main Methods:

• Analysis of survey data from two rounds of the Rakai Community Cohort Study (2018-2023).
• Estimation of prevalence ratios for PrEP awareness and ever-use.
• Inclusion of 15- to 24-year-old participants in south-central Uganda.

Main Results:

• 62.4% of AYAs were aware of PrEP, but only 1.7% had ever used it.
• Among eligible AYAs (35.5%), ever-use was 2.6%.
• Younger AYAs (15-19) had lower awareness and use compared to older AYAs (20-24). Participants from fishing communities showed higher awareness and use.

Conclusions:

• PrEP awareness is common among Ugandan AYAs, yet initiation is infrequent, even for eligible individuals.
• Barriers other than lack of awareness hinder PrEP uptake.
• Targeted interventions addressing these barriers are essential to reduce HIV incidence in this population, particularly for adolescents.