Evaluating factors associated with awareness and attitude towards pre-exposure prophylaxis among cisgender sexually active women in Ghana

BACKGROUND: HIV remains a public health issue globally and women continue to be disproportionately impacted. Pre-exposure prophylaxis (PrEP) is one critical intervention aimed at HIV prevention. However, awareness on PrEP remains suboptimal in most resource poor countries. Understanding the factors associated with PrEP awareness among sexually active women is an important part of the HIV prevention strategy. Therefore, we examined factors associated with awareness and attitude towards PrEP among cisgender sexually active women in Ghana. METHODS: This was a secondary analysis of the 2022 Ghana demographic and health survey (DHS) data involving a total of 3981 sexually active women aged 15-49 years. Percent and multiple logistic regression models were fitted to estimate prevalence and factors associated with PrEP awareness. All analyses were conducted using the "svy" command in STATA, version 18. Results were reported as adjusted odds ratio (aOR) and at 95% confidence interval (CI). RESULTS: Awareness on PrEP was low (20.0%). Sexually active women married/living with their partner were associated with 0.68 times the odds of PrEP awareness (0.47, 0.98). Women living in rural areas were associated with 0.60 times the odds of being aware of PrEP (0.47, 0.77). Women in the high-income bracket were associated with 1.50 higher odds of being aware of PrEP (1.17,1.93). Access to newspaper (1.84 1.06, 3.21), radio (1.88 1.43, 2.47) and television sets (1.55 1.14, 2.09) were associated with greater odds of PrEP awareness. Women who had heard about other STIs (1.64 1.20, 2.24), visited health facility (1.47 1.18, 1.84), visited by healthcare worker (1.50 1.12, 2.02), were aware of anti-retroviral therapy (ART) to treat HIV (3.86 2.69, 5.54), and had heard of HIV test kits (5.09 3.50, 7.39) were associated with greater odds of being aware of PrEP. Women with higher education were associated with greater odds of being aware about PrEP (3.34 2.25, 4.95). CONCLUSIONS: PrEP awareness among sexually active women in Ghana is low. Our findings can inform implementation of awareness campaigns on PrEP and increase its use and adherence among key populations.