Knowledge, attitude, and uptake of HIV pre-exposure prophylaxis among students in tertiary institutions in Calabar Metropolis, Nigeria

Abstract Background: Young people are disproportionately affected by human immunodeficiency virus (HIV) despite recent improvements in biomedical prevention strategies. Pre-exposure prophylaxis (PrEP) is an innovative prevention method that has shown significant promise in the fight against HIV. However, there is limited understanding of young people's knowledge and use of PrEP. This study assessed the knowledge, attitude, and uptake of PrEP among students in tertiary institutions in Calabar Metropolis, Nigeria. Methods: This study used a cross-sectional descriptive design to assess the knowledge, attitude, and uptake of PrEP among 420 students who were recruited using a multistage sampling technique. A structured questionnaire was utilized to obtain relevant data from participants on PrEP. Data were exported to and analyzed using Statistical Product and Service Solution (SPSS) version 26 to produce descriptive and inferential statistics. Results: Among respondents who have heard about PrEP (51.7%), more than half (58.1%) had a high level of knowledge of PrEP. Most of the respondents (84.3%) were willing to use PrEP in the future. PrEP use among the sexually active participants was poor, as only 13 (6%) have ever used it. Factors affecting the uptake of PrEP include lack of information on where and how to access PrEP (48.3%), lack of PrEP knowledge (46.5%), friend's disapproval (44.6%), unavailability (45%), fear of side effects (38.2%), and perception that PrEP could be expensive. Chi-square analysis showed that age (P = 0.033) and tribe (P < 0.001) were significantly associated with uptake of PrEP among participants. Conclusion: This study highlights the need to address abysmal PrEP uptake among participants by improving awareness and knowledge and translating participants' willingness to use PrEP into service uptake. Equally critical is leveraging multifaceted approaches to tackle identified barriers mitigating the use of PrEP among this group, whose vulnerability to HIV infection remains high.