{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:50:12Z","timestamp":1774612212139,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T00:00:00Z","timestamp":1644537600000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Zimbabwe is scaling up pre\u2010exposure prophylaxis (PrEP) for key populations, including men who have sex with men (MSM) and transgender women (TGW). To assess implementation and inform HIV programming, we evaluated gaps in PrEP awareness, uptake and use, and correlates of awareness and uptake among a sample of MSM, TGW and genderqueer individuals (GQ) in Harare and Bulawayo, Zimbabwe.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Respondent\u2010driven sampling was used to recruit 1194 MSM and 344 TGW\/GQ aged \u226518 to participate in a cross\u2010sectional survey assessing HIV\u2010related outcomes in 2019. Consenting participants completed a questionnaire on socio\u2010demographic information, sexual risk practices and engagement in HIV services and underwent HIV testing. Descriptive statistics were used to assess the PrEP cascade. Multiple logistic regression models were used to identify factors associated with PrEP awareness and uptake among HIV\u2010negative participants. Data were unweighted as the sample did not reach convergence on key estimates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 1167 HIV\u2010negative participants, most (79.2%) were MSM compared to TGW\/GQ (20.8%). Median age was 24 years. Overall, 45.8% were aware of PrEP and of those, 31.3% had ever taken PrEP. Most (71.1%) reporting never taking PrEP were willing to start PrEP; the main reasons for never starting PrEP included not knowing where to access it (24.8%) and fearing side effects (20.4%). Among those who had ever taken PrEP, 74.9% had taken PrEP in the last 6 months; of these, 42.4% had taken PrEP the day of or day preceding the survey. Side effects represented the most common (59.5%) reason for discontinuing PrEP. MSM (adjusted odds ratio [aOR]: 2.5, 95% confidence interval [CI]: 1.8\u20133.6) and TGW\/GQ in Harare (aOR: 3.1, 95% CI: 2.1\u20134.7), and TGW\/GQ in Bulawayo (aOR: 2.4, 95% CI: 1.1\u20135.3) had higher awareness of PrEP than MSM in Bulawayo. Overall, TGW\/GQ were more likely to have ever taken PrEP compared to MSM (aOR: 1.6, 95% CI: 1.01\u20132.4).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Findings emphasize the need for tailored interventions to promote PrEP among key populations. As HIV programs in Zimbabwe continue to expand PrEP services, these data, including barriers to starting and continuing PrEP, can inform strategies to address gaps along the PrEP cascade.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25873","type":"journal-article","created":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T16:30:00Z","timestamp":1644597000000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Engagement in the pre\u2010exposure prophylaxis (PrEP) cascade among a respondent\u2010driven sample of sexually active men who have sex with men and transgender women during early PrEP implementation in Zimbabwe"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5119-5811","authenticated-orcid":false,"given":"Lauren E.","family":"Parmley","sequence":"first","affiliation":[{"name":"ICAP at Columbia University  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2212-0874","authenticated-orcid":false,"given":"Tiffany G.","family":"Harris","sequence":"additional","affiliation":[{"name":"ICAP at Columbia University  New York New York USA"},{"name":"Department of Epidemiology, Mailman School of Public Health Columbia University  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Innocent","family":"Chingombe","sequence":"additional","affiliation":[{"name":"ICAP at Columbia University  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Munyaradzi","family":"Mapingure","sequence":"additional","affiliation":[{"name":"ICAP at Columbia University  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Owen","family":"Mugurungi","sequence":"additional","affiliation":[{"name":"Zimbabwe Ministry of Health and Child Care  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John H.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Division of Global HIV &amp; TB U.S. Centers for Disease Control  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Perpetua","family":"Gozhora","sequence":"additional","affiliation":[{"name":"ICAP at Columbia University  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingfeng","family":"Wu","sequence":"additional","affiliation":[{"name":"ICAP at Columbia University  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chesterfield","family":"Samba","sequence":"additional","affiliation":[{"name":"GALZ  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9077-4429","authenticated-orcid":false,"given":"Godfrey","family":"Musuka","sequence":"additional","affiliation":[{"name":"ICAP at Columbia University  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6754-6241","authenticated-orcid":false,"given":"Avi J.","family":"Hakim","sequence":"additional","affiliation":[{"name":"Division of Global HIV &amp; TB U.S. Centers for Disease Control  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,2,11]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"Zimbabwe Population\u2010based HIV Impact Assessment (ZIMPHIA) 2020: summary sheet","year":"2020"},{"key":"e_1_2_13_3_1","unstructured":"UNAIDS. 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