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3.2 PrEP clients
Most PrEP users are men who have sex with men (MSM), followed by transgender
women (TGW) and HIV-serodiscordant couples. A relatively higher proportion of serodiscordant
couples are found at hospital-based setting. Majority of PrEP clients have potential risk of HIV
infection due to sexual risk behaviors including having multiple partners and less/no condoms
use when having sexual intercourse while very few PrEP users reported of drug use or sharing
needle/syringe.
The most common reason to initiate PrEP was to protect themselves from HIV infection
apart from other prevention methods e.g. condom use. People who did not initiate PrEP after
being offered PrEP counseling service reported that they either did not have potential risk of
HIV infection or did not ready to take the medication and still had concern regarding drug
adverse effects. Those who discontinued PrEP were mainly due to having low or no potential
risk whereas individuals who ever stopped and restarted PrEP reported the reason as having
new potential risks for HIV infection. Majority of PrEP clients had good adherence with minimal
or no side effects. Most adverse events occurred at starting of medication and were well
tolerated after taking PrEP continuously for a longer period.
The most frequent reasons for not initiating PrEP were their perceived with no or low
risk in acquiring HIV infection, followed by concerns or inconvenience about taking daily PrEP,
and adverse events.
Figure 1 Self-administered risk assessment among PrEP clients (N = 513)
[216] Executive Summary
