AIDS and Behavior

, Volume 23, Issue 10, pp 2674–2686 | Cite as

Acceptability and Predictors of Uptake of Anti-retroviral Pre-exposure Prophylaxis (PrEP) Among Fishing Communities in Uganda: A Cross-Sectional Discrete Choice Experiment Survey

  • Monica O. KuteesaEmail author
  • Mathew Quaife
  • Sam Biraro
  • Kenneth R. Katumba
  • Janet Seeley
  • Anatoli Kamali
  • Damalie Nakanjako
Original Paper


We used a discrete choice experiment to assess the acceptability and potential uptake of HIV pre-exposure prophylaxis (PrEP) among 713 HIV-negative members of fishing communities in Uganda. Participants were asked to choose between oral pill, injection, implant, condoms, vaginal ring (women), and men circumcision. Product attributes were HIV prevention effectiveness, sexually transmitted infection (STI) prevention, contraception, waiting time, and secrecy of use. Data were analysed using mixed multinomial logit and latent class models. HIV prevention effectiveness was viewed as the most important attribute. Both genders preferred oral PrEP. Women least preferred the vaginal ring and men the implant. Condom use was predicted to decrease by one third among men, and not to change amongst women. Oral PrEP and other new prevention technologies are acceptable among fishing communities and may have substantial demand. Future work should explore utility of multiple product technologies that combine contraception with HIV and other STI prevention.


Fisherfolk HIV prevention Discrete choice experiment Pre-exposure prophylaxis Uganda 


Authors’ contribution

MOK, DN, SB, AK, contributed to the study design. MOK, MQ, DN, SB developed the study tools, MOK, DN, KK, oversaw implementation of the study. MOK, DN, and KK, and AK oversaw the data collection. MOK, and MQ, did the data analysis. MOK, and MQ, wrote the first draft of the manuscript. All authors contributed to the interpretation of the results and revision of the manuscript for coherence, and intellectual content.


This study was funded by the Health Resources & Service Administration U91HA06801B) and University of Washington Center for AIDS Research (CFAR), an NIH funded program (P30 AI027757) which is supported by the following NIH Institutes and Centers (NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA). The International Partnership for Microbicides (IPM) provided dummy vaginal rings for demonstration purposes.

Compliance with Ethical Standards

Conflict of interest

The authors have declared that no competing interests exist.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10461_2019_2418_MOESM1_ESM.docx (13 kb)
Supplementary material 1 (DOCX 13 kb)


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Copyright information

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Authors and Affiliations

  1. 1.Department of Infectious Disease EpidemiologyLondon School of Hygiene and Tropical MedicineLondonUK
  2. 2.HIV Interventions Program, MRC/LSHTM and LSHTM Uganda Research UnitEntebbeUganda
  3. 3.Department of Global Health and DevelopmentLondon School of Hygiene and Tropical MedicineLondonUK
  4. 4.ICAP, Columbia University, Mailman School of Public HealthNew YorkUSA
  5. 5.Social Aspects of Health Program, MRC/LSHTM and LSHTM Uganda Research UnitEntebbeUganda
  6. 6.International AIDS Vaccine InitiativeNairobiKenya
  7. 7.Department of Internal MedicineMakerere University College of Health SciencesKampalaUganda
  8. 8.Infectious Diseases InstituteMakerere University College of Health SciencesKampalaUganda

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