Assessment of the level of knowledge and attitudes towards long acting injectable HIV prevention among adolescent girls and young women at high risk of HIV infection at Makerere University

Abstract

Introduction: Over the past decade, global advancements in HIV prevention strategies have included the use of antiretroviral drugs for pre‐exposure prophylaxis (PrEP). PrEP has proven to be powerful in preventing HIV infection. Cabotegravir, an intramuscular long‐acting injectable PrEP (LAI‐PrEP), shows promise, achieving a 79% reduction in HIV risk compared to daily oral TDF‐based PrEP. However, little is known about how well Adolescent Girls and Young Women (AGYW), who are disproportionately affected by HIV understand and perceive this intervention. General objective: To assess the level of knowledge and attitudes of adolescent girls and young women at high-risk of HIV infection at Makerere University towards LAI‐PrEP and understand the perceived barriers and facilitators for its use in this group. Methods: We conducted a cross-sectional study from 24th March to 10th April, 2025 using an online Self-administered questionnaire. A total of 236 female students were recruited using quota sampling from the different colleges at Makerere University main campus. Of these, 167 were eligible or the study. Data was analysed using Microsoft excel and presented as descriptive statistics. Results: We found that 12.6% had heard of LAI-PrEP, only one had used it, and 24.0% had basic knowledge about LAI-PrEP. Generally, the respondents had a neutral bearing on LAI-PrEP’s usefulness and advantages with 37.5% willing to use it. Barriers and facilitators to LAI-PrEP use spanned institutional, interpersonal, and individual categories. Insufficient awareness campaigns (62.0%) and misinformation (57.8%) were the major deterrents. Key facilitators included increased awareness efforts (61.4%), and availability of emotional support from peers (57.8%). Conclusion: Awareness and knowledge of LAI-PrEP were low. Attitudes towards LAI-PrEP were predominantly neutral. The major barrier to its use was insufficient awareness campaigns. The key facilitator was increased awareness efforts. Participants emphasized the need for mass sensitization and use of media platforms for dissemination of information.