Abstract
Background: HIV remains an important public health issue throughout the world. In Côte d’Ivoire, a high burden of HIV is observed in men who have sex with men (MSM). Objective: We assessed the acceptability of Pre-Exposure Prophylaxis (PrEP) among men who have sex with men (MSM) in Bouaké, Côte d’Ivoire. Methods: We conducted and analysed four focus groups with 31 HIV-negative MSM and eight in-depth individual interviews with participants recruited from the focus groups. Results: Four MSM (13%) were aware of PrEP before participating in the study. All the participants were interested in taking PrEP if available: 19 (61.3%) would prefer the daily regimen and 12 (38.7%) would opt for the on-demand regimen. Many advantages of PrEP were mentioned: protection in case of a condom break, protection in case of high-risk sexual behaviour, self-reliance, decreasing HIV fear and ease of use. Barriers to the use of PrEP included: it does not protect against other Sexually Transmitted Tnfections (STIs), taking a pill regularly is necessary, the size of the pill, possibility of side effects, the cost and accessibility. Six participants (19.3%) admitted that they would use condoms less if they take PrEP. Conclusion: Findings indicate that PrEP is acceptable within the MSM community. Implementation should be done rapidly, and PrEP should be part of a global prevention program which includes counselling, STI screening and promotion of safe sex practices. Health authorities should consider PrEP for all high-risk groups to avoid worsening stigmatization by targeting MSM only.
Highlights
Findings indicate that Pre-Exposure Prophylaxis (PrEP) is acceptable within the men who have sex with men (MSM) community
The results indicate that there is a high level of PrEP acceptability within the MSM population in Bouaké
Access to all MSM should be promoted by making PrEP available in both public health amenities and Non-Governmental Organization (NGO) with health care facilities
Summary
In addition to the social stigma surrounding homosexuality [5, 8], the fact that MSM have not been identified as a key population in SSA earlier has contributed to the current lack of specific services for this population. Côte d’Ivoire is the second West African country with the highest HIV burden, with an estimated HIV prevalence of 2.7% [IC 2.2-3%] in 2016 [9]. Despite a decline in the general population during the last decade, HIV prevalence remains high within key populations, including MSM. The stigmatization towards MSM in this country contributes to the lack of targeted health services and predisposes these men to high risk sexual behaviours [11, 12]. In Côte d’Ivoire, a high burden of HIV is observed in men who have sex with men (MSM)
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