Assessing Knowledge and Awareness of HIV Pre-exposure Prophylaxis (PrEP) Among University Students in Nkurenkuru Town, Namibia
Abstract:
Pre-exposure prophylaxis (PrEP) is an effective biomedical strategy for preventing HIV transmission; however, its impact depends on adequate awareness, understanding, and willingness to use it, particularly among vulnerable groups such as university students. Evidence on PrEP awareness in semi-rural settings like Nkurenkuru Town, Namibia, remains limited. This cross-sectional study, conducted from January to December 2023 among 200 university students, used a structured self-administered questionnaire, with data analyzed using descriptive statistics and chi-square tests. Findings revealed low awareness, with only 25% of participants having heard of PrEP and just 10% demonstrating adequate knowledge of its use. Digital platforms (38.5%) and healthcare workers (30.5%) were the main information sources. Despite limited awareness, 72.5% of students expressed willingness to use PrEP if recommended by a healthcare professional. A significant association was found between prior awareness and willingness to use PrEP, with higher acceptance among those aware of it (90.0%) compared to those unaware (66.7%) (χ²=13.67, p=0.008). Although better knowledge was associated with greater willingness (90.0% vs. 70.6%), this was not statistically significant (χ²=3.41, p=0.065). Overall, while willingness to use PrEP is high, awareness and knowledge remain insufficient, highlighting the need for targeted educational interventions and increased involvement of healthcare providers to improve uptake among university students.References:
[1]. UNAIDS. Namibia country report. 2020. Available from: https://www.unaids.org/en/regionscountries/countries/namibia
[2]. Shikwambi E, Strode A. Assessment of HIV prevention
knowledge, attitudes, and behavior among University of Namibia students. Afr J
AIDS Res. 2019;18(1):63-72.
[3]. Peltzer K, Pengpid S. Knowledge, attitudes, and
acceptability of pre-exposure prophylaxis among university students in the
Western Cape, South Africa. PLoS One. 2018;13(10):e0205246.
[4]. Hlongwa M, Mashamba-Thompson TP, Makhunga-Ramfolo N.
Knowledge, attitudes, and practices regarding pre-exposure prophylaxis among
university students in South Africa: a systematic review. AIDS Res Hum
Retroviruses. 2020;36(1):1-13.
[5]. Gareta D, Nhandara C. Knowledge, attitudes and
practices on HIV prevention among university students in Zimbabwe: a systematic
review. BMC Infect Dis. 2019;19(1):778.
[6]. Nangombe ND, Chivule J, Kazaize T, et
al. Knowledge, attitude and practice of
pre-exposure prophylaxis among students in a university in Nkurenkuru, Namibia.
Afr J Reprod Health. 2020;24(1):136-45.
[7]. Muthelo E, Shikwambi K. Assessing the knowledge and
attitudes of university students towards pre-exposure prophylaxis for HIV
prevention in Nkurenkuru, Namibia. Int J Health Sci. 2019;7(2):23-32.
[8]. Lehoboro A, Godfrey-Faussett P,
Andrianantoandro T, et al. Barriers to
pre-exposure prophylaxis uptake among university students in South Africa. AIDS
Care. 2020;32(7):899-908.
[9]. Mabaso M, Nxumalo Z, Van Rooyen H. Knowledge and
awareness of pre-exposure prophylaxis among university students in South
Africa: a systematic review. S Afr J HIV Med. 2021;22(1):a1270.
[10]. Ndlovu N, Van Zyl C, Mabaso M, et al. Knowledge and attitudes towards pre-exposure
prophylaxis for HIV prevention. 2021.
[11]. Nyanza EC, Himunzowa GR, Mufune P, et al. Knowledge,
attitudes, and barriers to pre-exposure prophylaxis among university students
in Lusaka, Zambia. J AIDS Clin Res. 2020;11(7):872.
[12]. Chipungu J, Magadzire BP, Musemburi K,
et al. Awareness, knowledge, and attitudes
towards pre-exposure prophylaxis among college students in Harare, Zimbabwe.
Int J Environ Res Public Health. 2022.
[13]. Ayinde BO, Ilesanmi OS. Knowledge and awareness of
HIV/AIDS among university students in Southern Africa. Afr J Reprod Health.
2000.
[14]. Robbertse D, Strümpher J. Awareness and knowledge of
pre-exposure prophylaxis among university students in South Africa. S Afr J HIV
Med. 2018;19(1):1-5.
[15]. Sherwood J, Copas A, Garrett N. Barriers and
facilitators to HIV pre-exposure prophylaxis uptake among university students:
a systematic review. AIDS Behav. 2020;24(10):2783-97.
[16]. Paphitis N, Schneider H, Khati M. PrEP knowledge and
attitudes among university students in southern Africa: a scoping review. S Afr
J HIV Med. 2020;21(1):1-8.
[17]. Li DH, Huynh J, Krieger D, et al. Knowledge and intentions to use pre-exposure
prophylaxis among high-risk populations in Europe: a systematic review. BMC
Public Health. 2019;19(1):1-13.
[18]. Gianella S, Taylor J. Challenges of implementing
pre-exposure prophylaxis in Europe and the United States. Curr Opin HIV AIDS.
2017;12(6):574-80.
[19]. Wei C, Herrick A, Raymond HF, et al. Knowledge and
intentions regarding pre-exposure prophylaxis among transgender women in the
San Francisco Bay Area. LGBT Health. 2020;7(2):100-6.
[20]. Smith J, Johnson A, Thompson L. Knowledge, attitudes,
and practices regarding pre-exposure prophylaxis among university students in
Nkurenkuru, Namibia. 2021.
[21]. Williams R, Adams K, Brown M. Effectiveness of PrEP
knowledge campaigns among university students in Nkurenkuru.
[22]. Garcia L, Martinez S, Rodriguez E. Socio-demographic
factors affecting pre-exposure prophylaxis knowledge among university students
in Nkurenkuru. 2021.
[23]. Lee C, Patel K, Anderson S. Knowledge, perceptions,
and preferences of university students in Nkurenkuru regarding pre-exposure
prophylaxis. 2021.
[24]. Grossman J, Amanda M, Linda C, Ineke C, Sumru E. Youth
perspectives on sexuality communication with parents and extended family. 2018.
[25]. Khosropour CM, Dombrowski JC, Hughes JP, et al.
Operationalizing HIV pre-exposure prophylaxis referral and initiation in a
sexually transmitted disease clinic. Sex Transm Dis. 2017;44(6):366-71. https://doi.org/10.1097/OLQ.0000000000000602
[26]. Brown JL, Vanable PA, Carey MP. Barriers and
facilitators to HIV pre-exposure prophylaxis uptake among young adults: a
systematic review. AIDS Behav. 2019;23(10):2736-54.
[27]. Adebajo S, Eluwa G, Njab J, et al. Awareness and
willingness to use pre-exposure prophylaxis among men who have sex with men in
Nigeria. J Int AIDS Soc. 2018;21(2):e25062. https://doi.org/10.1002/jia2.25062
[28]. World Health Organization. Guidelines on
antiretroviral therapy and pre-exposure prophylaxis for HIV. Geneva: World
Health Organization; 2015.
[29]. UNAIDS. Global AIDS update: Communities at the centre.
Geneva: UNAIDS; 2019.
[30]. Muwonge TR, Nsubuga R, Mirembe FM. Knowledge,
attitudes, and barriers to pre-exposure prophylaxis among university students
in Uganda. BMC Public Health. 2021;21:1214.
[31]. Golub SA, Gamarel KE, Rendina HJ, et al.
Facilitators and barriers to PrEP
uptake among young adults. J Acquir Immune Defic Syndr. 2017;74(5):520-8.
[32]. Pintye J, Beima-Sofie K, Ngure K, et al. Digital media
and PrEP awareness among young adults in sub-Saharan Africa. J Int AIDS Soc.
2020;23(S3):e25530.
[33]. Cochran WG. Sampling techniques. 3rd ed. New York:
John Wiley & Sons; 1977.
[34]. Lwanga SK, Lemeshow S. Sample size determination in
health studies. Geneva: World Health Organization; 1991.
[35]. Kish L. Survey sampling. New York: John Wiley &
Sons; 1965.
[36]. Daniel WW, Cross CL. Biostatistics: a foundation for
analysis in health sciences. 10th ed. Hoboken: Wiley; 2013.
[37]. Charan J, Biswas T. Sample size calculation in medical
research. Indian J Psychol Med. 2013;35(2):121-6.
[38]. Ministry of Health and Social Services Namibia, et al.
Namibia Population-Based HIV Impact Assessment (NAMPHIA) 2017 final report.
Windhoek: MoHSS; 2019.
[39]. Grasso MA, Hamunime N, Maher AD, et al. Improving HIV
testing and linkage to care: lessons from NAMPHIA 2017. AIDS Care.
2021;33(10):1308-11.
[40]. Kampamba M, Nelumbu NN, Hikaambo CN, Mudenda S, Hangoma JM, Kunda M, Mufwambi W, Hamachila A, Mukosha M. Awareness and willingness to use pre-exposure prophylaxis among the University of Zambia students: a cross-sectional study. Health Sci Rep. 2024;7(9):e70060. doi:10.1002/hsr2.70060.
