Knowledge and Acceptability of HIV pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) in Ghana

ABSTRACT

In Ghana, men who have sex with men (MSM) are disproportionately affected by HIV. Pre-exposure prophylaxis (PrEP) is a biomedical intervention that reduces the risk of HIV infection but is not currently available in Ghana. This paper explores knowledge and acceptability of HIV PrEP among Ghanaian MSM. Qualitative content analysis was conducted on 22 focus group discussions (N = 137) conducted between March and June 2012 in Accra, Kumasi, and Manya Krobo. Overall, participants reported low knowledge of PrEP. However, once information about PrEP was provided, there was high acceptability. The primary reason for acceptability was that PrEP provided an extra level of protection against HIV. Acceptability of PrEP was conditioned on it having minimal side effects, being affordable and efficient in preventing HIV infection. No acceptability of PrEP was attributed to limited knowledge of side effects and perceived lack of effectiveness. The reasons provided to utilize PrEP and condoms were that condoms protect against other STIs, and sexual partner factors. This is the first known study to explore PrEP knowledge and acceptability among Ghanaian MSM. It is important that key stakeholders preemptively address potential barriers to PrEP acceptability, uptake, and adherence, especially among MSM, once PrEP becomes available in Ghana.

KEYWORDS:

• PrEP
• Ghana
• MSM
• Acceptability
• HIV
• Africa
• HIV Prevention
• HIV/AIDS

Acknowledgements

First, we will like to thank all the research participants who shared their insight. We thank all the local community partners in Ghana: Otumfuo Osei Tutu II Charity Foundation, Centre for Popular Education & Human Rights Ghana, Priorities on Rights and Sexual Health, Suntreso Government Hospital, Asesewa Government Hospital, Eastern Region HIV/STI program, Ashanti Region HIV/STI program, and the Office of the Konor of Manya Krobo Traditional Area. We thank Dr Vanessa Apea (Barts & The Royal London Hospital), Nene Sakite II Konor of Manya Krobo, Nene Kwasi Kafele (York University), Dr Francis Addai (Ghana Health Services), Dr Francis Arko Akoto-Ampaw (Ghana Health Services), Enock Amankwah (University of South Florida) Nana Yaw Atakora-Yeboah and Sulaimon O. Giwa (York University).

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Direct expenses for this research were primarily provided by Grand Challenges Canada grant [CRS0024–0101]. Additionally, this research was supported, in part, by the National Institute on Drug Abuse [DA047216](principal investigator [PI]: Adedotun Ogunbajo, PhD (c)), the National Institute of Mental Health under [R25MH083620] [PI]: Amy Nunn, PhD) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development [P2C HD041020] (PI: Susan Short, PhD), for which the first author is a trainee but did not support project-specific expenses. This work was also supported by the Robert Wood Johnson Foundation Health Policy Research Scholars Program, for which the first author is a scholar but did not support project-specific expenses. The University of Rochester School of Nursing Dean’s Endowed Fellowship in Health Disparities supports LN. This publication was also made possible through core services supported by grant [P30 AI078498] to the University of Rochester Center for AIDS Research (CFAR) from the National Institute of Allergy & Infectious Diseases, which supports LN.