Background
Methods
Study design, setting and population
Data Collection
Statistical analysis
Ethical considerations
Results
Demographic and clinical characteristics of the participants
Participant characteristic | Males: n (weighted %) | Female: n (weighted %) | Total: n (weighted % or interquartile range) |
---|---|---|---|
Total | 6,432 (51.3) | 7,563 (48.7) | 13,995 |
Median age in years | 30 (23–42) | 28 (22–38) | 29 (22–40) |
Age categories in years | |||
15–19 | 826 (12.8) | 887 (14.5) | 1,713 (13.6) |
20–24 | 1,174 (18.2) | 1,718 (21.7) | 2,892 (19.9) |
25–29 | 910 (16.4) | 1,413 (18.6) | 2,323 (17.5) |
30–34 | 774 (13.7) | 965 (13.6) | 1,739 (13.6) |
35–39 | 693 (10.4) | 884 (10.0) | 1,577 (10.2) |
40–44 | 538 (7.7) | 564 (7.0) | 1,102 (7.4) |
45–50 | 446 (6.1) | 432 (5.2) | 878 (5.7) |
50+ | 1,071 (14.7) | 700 (9.4) | 1,771 (12.1) |
Zone | |||
North | 839 (13.4) | 868 (12.2) | 1,707 (12.8) |
Central East | 1,262 (19.3) | 1,315 (16.7) | 2,577 (18.1) |
Central West | 981 (22.1) | 1,082 (22.0) | 2,063 (22.0) |
Lilongwe City | 294 (4.8) | 421 (5.7) | 715 (5.2) |
South East | 1,373 (17.7) | 1,875 (20.0) | 3,248 (18.9) |
South West | 1,356 (17.9) | 1,631 (18.7) | 2,987 (18.3) |
Blantyre City | 327 (4.7) | 371 (4.7) | 698 (4.7) |
Highest level of school respondent ever attended | |||
No education | 429 (6.4) | 845 (11.2) | 1,274 (8.7) |
Primary | 3,793 (58.2) | 4,956 (65.2) | 8,749 (61.6) |
Secondary | 1,921 (30.6) | 1,574 (21.0) | 3,495 (25.9) |
More than secondary | 284 (4.8) | 184 (2.5) | 468 (3.7) |
Residence | |||
Urban | 993 (16.6) | 1,267 (15.8) | 2,260 (16.2) |
Rural | 5,439 (83.4) | 6,296 (84.2) | 11,735 (83.8) |
Marital status | |||
Never married | 1,615 (26.0) | 824 (12.7) | 2,439 (19.5) |
Married or living together | 4,526 (69.7) | 5,884 (76.5) | 10,410 (73.0) |
Divorced or separated | 273 (4.1) | 777 (9.9) | 1,050 (6.9) |
Widowed | 15 (0.2) | 73 (1.0) | 88 (0.6) |
Wealth quintile | |||
Lowest | 1,096 (17.7) | 1,399 (19.3) | 2,495 (18.5) |
Second | 1,346 (20.7) | 1,566 (20.8) | 2,912 (20.7) |
Middle | 1,290 (19.6) | 1,555 (19.9) | 2,845 (19.8) |
Fourth | 1,425 (21.8) | 1,528 (19.7) | 2,953(20.8) |
Highest | 1,274 (20.2) | 1,514 (20.2) | 2,788 (20.2) |
Awareness of PrEP and factors associated with PrEP awareness
Characteristic | Aware of oral PrEP (N = 13,995) | ||||
---|---|---|---|---|---|
Weighted % (95% CI) | Unadjusted Odds Ratio (95% CI) | p-value | Adjusted Odds Ratio (95% CI) | p-value | |
Total | 15.0 (14.2–15.9) | - | - | - | - |
Gender | |||||
Female | 12.5 (11.6–13.4) | Ref | - | Ref | - |
Male | 17.3 (16.2–18.5) | 1.5 (1.3–1.6) | < 0.001 | 1.3 (1.2–1.5) | < 0.001* |
Zone | |||||
North | 18.2 (15.5–21.3) | Ref | - | Ref | - |
Central East | 13.1 (11.4–15.1) | 0.7 (0.5–0.9) | 0.005 | 0.8 (0.6-1.0) | 0.023* |
Central West | 11.1 (9.2–13.3) | 0.6 (0.4–0.7) | < 0.001 | 0.7 (0.5–0.9) | 0.002* |
Lilongwe City | 19.7 (15.9–24.1) | 1.1 (0.8–1.5) | 0.556 | 0.6 (0.4–0.9) | 0.008* |
South East | 14.8 (13.2–16.5) | 0.8 (0.6-1.0) | 0.042 | 0.9 (0.7–1.1) | 0.442 |
South West | 16.1 (14.5–17.9) | 0.9 (0.7–1.1) | 0.196 | 1.0 (0.8–1.2) | 0.910 |
Blantyre City | 22.5 (18.2–27.6) | 1.3 (0.9–1.8) | 0.118 | 0.7 (0.5-1.0) | 0.051 |
Age in years | |||||
15–19 | 13.5 (11.6–15.5) | Ref | - | Ref | - |
20–24 | 15.2 (13.6–16.8) | 1.2 (0.9–1.4) | 0.195 | 1.1 (0.9–1.4) | 0.306 |
25–29 | 16.5 (14.9–18.3) | 1.3 (1.0-1.6) | 0.027* | 1.2 (0.9–1.6) | 0.135 |
30–34 | 16.8 (14.8–19.1) | 1.3 (1.0-1.6) | 0.026 | 1.3 (1.0-1.7) | 0.07 |
35–39 | 15.3 (13.3–17.6) | 1.2 (0.9–1.4) | 0.185 | 1.2 (0.9–1.6) | 0.174 |
40–44 | 16.5 (14.2–19.1) | 1.3 (1.0-1.6) | 0.063 | 1.3 (0.8–1.8) | 0.055 |
45–50 | 12.9 (10.8–15.4) | 0.9 (0.7–1.2) | 0.681 | 1.1 (0.8–1.4) | 0.699 |
50+ | 11.6 (10.1–13.3) | 0.8 (0.7–1.1) | 0.131 | 1.0 (0.7–1.3) | 0.851 |
Highest level of school respondent ever attended | |||||
No education | 10.6 (8.7–12.8) | Ref | - | Ref | - |
Primary | 11.8 (11.0-12.6) | 1.1 (0.9–1.4) | 0.257 | 1.0 (0.8–1.2) | 0.953 |
Secondary | 20.4 (18.8–22.1) | 2.2 (1.7–2.8) | < 0.001 | 1.5 (1.2-2.0) | 0.002* |
More than secondary | 40.6 (35.5–45.9) | 5.8 (4.2–7.9) | < 0.001 | 3.4 (2.4–4.9) | < 0.001* |
Urban/rural area Indicator | |||||
Rural | 13.5 (12.7–14.3) | Ref | - | Ref | - |
Urban | 22.6 (20.1–25.3) | 1.9 (1.6–2.2) | < 0.001 | 1.3 (1.0-1.7) | 0.064 |
Marital status | |||||
Never married | 18.3 (16.6–20.3) | Ref | - | Ref | - |
Married or living together | 14.2 (13.3–15.1) | 0.7 (0.6–0.8) | < 0.001 | 0.9 (0.7–1.1) | 0.261 |
Divorced or separated | 13.8 (11.5–16.3) | 0.7 (0.6–0.9) | 0.006 | 0.9 (0.7–1.2) | 0.512 |
Widowed | 12.0 (6.4–21.3) | 0.6 (0.3–1.2) | 0.158 | 0.8 (0.4–1.6) | 0.524 |
Wealth quintile | |||||
Lowest | 10.6 (9.2–12.1) | Ref | - | Ref | - |
Second | 11.5 (10.2–12.9) | 1.1 (0.9–1.3) | 0.316 | 1.0 (0.9–1.2) | 0.717 |
Middle | 13.5 (12.1–14.9) | 1.3 (1.1–1.6) | 0.007 | 1.2 (1.0-1.4) | 0.124 |
Fourth | 15.3 (13.9–16.9) | 1.5 (1.3–1.8) | < 0.001 | 1.2 (1.0-1.5) | 0.035 |
Highest | 23.7 (21.6–25.9) | 2.6 (2.1–3.2) | < 0.001 | 1.6 (1.2-2.0) | 0.001 |
Willingness to use and factors associated with willingness to use PrEP
Characteristic | Willing to use oral PrEP | ||||
---|---|---|---|---|---|
Weighted % (95% CI) | Unadjusted Odds Ratio (95% CI) | P-value | Adjusted Odds Ratio (95% CI) | P-value | |
Total | 73.0 (71.8–74.1) | - | - | - | - |
Gender | |||||
Female | 71.2 (69.8–72.6) | Ref | - | Ref | - |
Male | 74.7 (73.3–76.0) | 1.2 (1.1–1.3) | < 0.001 | 1.2 (1.1–1.3) | 0.001* |
Zone | |||||
North | 78.7 (75.3–81.7) | Ref | - | Ref | - |
Central East | 73.9 (71.5–76.1) | 0.8 (0.6-1.0) | 0.022 | 0.7 (0.6–0.9) | 0.013* |
Central West | 67.6 (64.9–70.2) | 0.6 (0.5–0.7) | < 0.001 | 0.6 (0.4–0.7) | < 0.001* |
Lilongwe City | 68.8 (65.6–71.8) | 0.6 (0.5–0.8) | < 0.001 | 0.6 (0.5–0.9) | 0.008* |
South East | 77.0 (74.8–79.2) | 0.9 (0.7–1.1) | 0.394 | 0.9 (0.7–1.1) | 0.273 |
South West | 71.4 (68.6–74.1) | 0.7 (0.5–0.9) | 0.002 | 0.7 (0.5–0.8) | 0.001* |
Blantyre City | 73.5 (69.4–77.2) | 0.8 (0.6-1.0) | 0.038 | 0.8 (0.6–1.2) | 0.300 |
Age in years | |||||
15–19 | 77.6 (75.2–79.9) | Ref | - | Ref | - |
20–24 | 74.8 (72.7–76.7) | 0.9 (0.7-1.0) | 0.043* | 0.8 (0.7-1.0) | 0.032 |
25–29 | 75.3 (73.2–77.4) | 0.9 (0.7–1.1) | 0.149 | 0.9 (0.7–1.1) | 0.192 |
30–34 | 71.4 (69.1–73.6) | 0.7 (0.6–0.8) | < 0.001 | 0.7 (0.6–0.9) | 0.004* |
35–39 | 72.1 (69.7–74.3) | 0.7 (0.6–0.9) | 0.001* | 0.8 (0.6–0.9) | 0.016* |
40–44 | 72.6 (69.3–75.7) | 0.8 (0.6–0.9) | 0.012 | 0.8 (0.6–1.1) | 0.113 |
45–49 | 70.3 (67.1–73.4) | 0.7 (0.6–0.8) | < 0.001 | 0.7 (0.6–0.9) | 0.018* |
50+ | 65.3 (62.6–67.9) | 0.5 (0.5–0.6) | < 0.001* | 0.6 (0.5–0.7) | < 0.001* |
Highest level of school attended | |||||
No education | 67.0 (63.6–70.1) | Ref | - | Ref | - |
Primary | 73.2 (71.9–74.5) | 1.3 (1.2–1.6) | < 0.001 | 1.1 (1.0-1.3) | 0.117 |
Secondary | 75.0 (73.3–76.7) | 1.5 (1.3–1.7) | < 0.001 | 1.2 (1.0-1.4) | 0.074 |
More than secondary | 68.1 (63.3–72.6) | 1.1 (0.8–1.4) | 0.685 | 1.0 (0.7–1.3) | 0.824 |
Residence | |||||
Urban | 72.0 (69.7–74.1) | Ref | - | Ref | - |
Rural | 73.2 (71.8–74.4) | 1.1 (0.9–1.2) | 0.346 | 0.9 (0.7–1.2) | 0.439 |
Marital status | |||||
Never married | 77.0 (74.7–79.1) | Ref | - | Ref | - |
Married or living together | 71.4 (70.2–72.6) | 0.7 (0.7–0.9) | < 0.001 | 1.0 (0.8–1.2) | 0.834 |
Divorced or separated | 77.8 (74.8–80.5) | 1.0 (0.9–1.3) | 0.635 | 1.2 (1.0-1.6) | 0.084 |
Widowed | 74.7 (63.1–83.6) | 0.9 (0.5–1.5) | 0.628 | 1.5 (0.8–2.8) | 0.153 |
Wealth quintile | |||||
Lowest | 71.8 (69.2–74.2) | Ref- | - | Ref | - |
Second | 73.8 (71.8–75.7) | 1.1 (1.0-1.3) | 0.113 | 1.0 (0.9–1.2) | 0.661 |
Middle | 74.0 (71.8–76.1) | 1.1 (1.0-1.3) | 0.150 | 1.1 (0.9–1.3) | 0.487 |
Fourth | 73.2 (71.1–75.1) | 1.1 (0.9–1.3) | 0.366 | 1.0 (0.9–1.2) | 0.896 |
Highest | 72.0 (69.6–74.2) | 1.0 (0.9–1.2) | 0.900 | 0.9 (0.8–1.1) | 0.483 |
Number of sexual partners | |||||
1 | 71.1 (69.9–72.3) | Ref | - | Ref | - |
2 or more | 82.2 (80.2–84.0) | 1.9 (1.6–2.1) | < 0.001 | 1.7 (1.4–1.9) | < 0.001* |
Previous HIV test ≤ 12 months | |||||
Never tested | 70.9 (68.0-73.7) | Ref | - | Ref | - |
Yes | 74.7 (73.2–76.1) | 1.4 (1.2–1.7) | 0.001 | 1.3 (1.1–1.5) | 0.008* |
No | 72.0 (70.2–73.5) | 1.2 (1.0-1.4) | 0.096 | 1.1 (0.9–1.3) | 0.179 |