Decomposing Education-Based Inequalities in Pre-Exposure Prophylaxis Knowledge for HIV Prevention Among Women in Cote d’Ivoire

Abstract

Background

Antiretroviral chemoprophylaxis is a promising strategy for preventing the spread of human immunodeficiency virus (HIV). The knowledge of pre-exposure prophylaxis (PrEP) is required for intervention uptake and adherence to prevent the spread of HIV. This study aimed to decompose education-based inequalities in PrEP knowledge for HIV prevention among reproductive-aged women in Cote d’Ivoire.

Methods

A cross-sectional study design with a nationally representative sample of 12,934 women aged 15–49 years was analyzed from the 2021 Cote d’Ivoire Demographic and Health Survey. The survey was conducted between September to December, 2021. The outcome variable was the knowledge of PrEP for HIV prevention. Statistical analysis was conducted using percentage, concentration index, and Lorenz curve. The level of significance was set at p<0.05.

Results

A weighted prevalence of 14.5% (95% CI: 12.5–16.3%) was estimated for PrEP knowledge for HIV prevention. Overall, educated women had a higher knowledge of PrEP for HIV prevention (Conc. Index= 0.225; SE= 0.012; p<0.001). Across the levels of women’s characteristics, the results showed higher PrEP knowledge for HIV prevention among educated women. Education (Contri: 40.7327%, E_c: 0.5390), exposure to internet (Contri: 20.1039%, E_c: 0.3484), place of residence (Contri: 12.9801%, E_c: −0.0537), household wealth (Contri: 10.0062%, E_c: 0.0642) and religion (Contri: 5.7509%, E_c: 0.0354) were positive contributors to PrEP knowledge for HIV prevention. On the other hand, age (Contri: −8.8298%, E_c: −0.0950) and region (Contri: −3.5942, E_c: −0.0768) were negative contributors to PrEP knowledge regarding HIV prevention among women of reproductive age in Cote d’Ivoire.

Conclusion

There is limited knowledge of PrEP for HIV prevention among women in Cote d’Ivoire. Educated women had greater knowledge of PrEP for HIV prevention. The results of this study could guide interventions targeted to enhance the knowledge of PrEP as an HIV prevention option.

Keywords:

• ivory coast
• Sub-Saharan Africa
• PrEP
• women
• HIV/AIDS

Data Sharing Statement

Data for this study were sourced from Demographic and Health surveys (DHS) and available here: http://dhsprogram.com/data/available-datasets.cfm.

Ethical Approval and Consent to Participate

This study is a secondary data analysis, which is publicly available; approval was sought from MEASURE DHS/ICF International and permission was granted for this use. The original DHS data were collected in conformity with international and national ethical guidelines. Written consent was obtained from the mothers/caregivers, and data were recorded anonymously at the time of data collection during the data collection. More details regarding DHS data and ethical standards are available at: http://dhsprogram.com/data/availabledatasets.cfm.

Acknowledgments

The authors appreciate the MEASURE DHS project for its approval and access to the original data.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare no potential conflicts of interest with respect to the research, authorship, or publication of this article.

Additional information

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.