Using the social ecological model to understand the factors that influence the attitudes women have towards the use of pre-exposure prophylaxis for the prevention of HIV in Uganda

The use of biomedical means of HIV prevention, such as pre-exposure prophylaxis (PrEP), is effective in reducing HIV infection in high-risk groups that include women. Regardless of the known efficacy of PrEP, the number of women using PrEP in Uganda is still low. People's decisions to engage in a health behaviour, in this case, PrEP, is influenced by the attitudes and perceptions they have towards it. This study explored the factors that influence women's attitudes and decisions to use PrEP. Qualitative methods were used to collect data from women aged 18-45 years, health workers, and female community leaders in Kampala and Wakiso districts. The social ecological model was utilised to examine the factors influencing attitudes towards PrEP. Knowing PrEP availability, efficacy, access points, support of people in their circles, personal risk assessment of HIV infection, cultural and societal norms, and accessibility of PrEP-providing facilities were noted as factors that influence attitudes towards PrEP. Improving PrEP initiation among women calls for increased public sensitisation on PrEP, aimes at reducing stigma. Interventions targeting married women should involve their partners. Increasing the number of PrEP providing sites. Multi-level interventions should be formulated to address constraints at the different levels of society.