RESEARCH ARTICLE


Pre-Exposure Prophylaxis (PrEP) in Men Who have Sex with Men in Bouaké, Côte d’Ivoire: A Qualitative Evaluation of Acceptability



Sara Jeanne Pelletier1, Marie-Pierre Gagnon1, Souleymane Diabaté1, 2, Ouffoué Kra2, Yadjoro Josué Biékoua3, Gbahonnon Dorothée Osso3, Bamourou Diané2, Méliane N’Dhatz-Ebagnitchié2, Carin Ahouada4, Michel Alary1, *
1 Centre de recherche du CHU de Québec-Université Laval, Québec, QC, G1S 4L8 Canada
2 Université Alassane Ouattara, Bouaké, Côte d’Ivoire
3 Renaissance Santé Bouaké, Bouaké, Côte d’Ivoire
4 Centre National Hospitalier Universitaire de, Cotonou Benin


© 2019 Pelletier et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Centre de recherche du CHU de Québec – Université Laval, 1050, Chemin Sainte-Foy, local H0-02, Québec, Qc, G1S 4L8, Canada; Tel: 1-418-525-4444 p.87387; Fax: 1-418-682-7949;
E-mail: michel.alary@crchudequebec.ulaval.ca


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.

Keywords: PrEP, HIV, MSM, Côte d’Ivoire, Acceptability, Prevention.