Published in PLOS One on 2026-06-08, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Maiya G. Block Ngaybe, Kawoya K. Joseph, Wadana Hamzazai, Carly J. Deal, Stephen Mugamba, Wambi M. Stephen, Richard Muhumuza, Betty Nakaggwa, Auwal Abubakar, Gabriela Valdez, Maia Ingram, John Ehiri, Grace Mirembe, Betty Mwesigwa, Hannah Kibuuka, Purnima Madhivanan
Source: PLOS One • DOI 10.1371/journal.pone.0349414
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Long-acting injectable pre-exposure prophylaxis (PrEP) has recently been approved for use, and dissemination, but has yet to be released in Uganda. To ensure uptake of this injectable option, and others like a future HIV vaccine, it is important to understand the preferences of the populations at the highest risk who will benefit the most. We present data on product preferences for HIV prevention practices and injectable HIV prevention among populations most at risk for HIV with a focus on injectable options such as long-acting PrEP or a future HIV Vaccine for primary prevention of HIV. From March 18–28, 2024, we conducted 20 semi-structured key informant interviews in English and Luganda among 10 experts in the field of HIV prevention, and 10 peer leaders of key or priority populations in Uganda. Participants were purposively selected to represent various groups, genders, occupations and locations to get diverse perspectives. Participants were included if they were determined to be at risk of contracting HIV and were above the age of 18. Both groups of participants were asked similar questions, with experts focusing on their experience with key populations, populations who are particularly vulnerable to HIV acquisition due to a combination of behavioral, biological, and social factors. Debriefs were held after each interview to monitor emerging themes and assess data saturation. The most common prevention practices mentioned by participants were condoms and PrEP. Participants mentioned barriers to prevention practices including duration (i.e., dosing length), accessibility issues such as transportation, location issues (i.e., distance), and stigma. The most important characteristics for participants when considering the uptake of a new injectable prevention product included efficacy, cost and side effects. Experts tended to believe that efficacy levels should be higher than peer leaders with lived experience. Participants who were peer leaders recognized that some had a fear of needles, though they also expressed motivation to receive injections due to the perception that they may work better than other modes of administration. According to experts and peer leader participants in this study, key populations in Uganda prefer high efficacy, lower side effects and confidentiality in their services. Participants emphasized the need for comprehensive and accessible information about specific HIV prevention methods to improve the uptake of these products. Tailored messaging and choice can accommodate the heterogeneity of preferences to best ensure HIV prevention in Uganda.
Introduction
Human immunodeficiency virus (HIV) affects approximately 39.9 million people worldwide with an incidence rate of 1.3 million individuals per year [1,2]. Sub-Saharan Africa bears a disproportionate burden of the global HIV epidemic, with Uganda ranking among the top five countries with the highest prevalence of people living with HIV [3]. The national prevalence hovers around 5.4%, with a higher concentration of cases in urban areas and among key populations, e.g., people who sell or exchange sex, people who inject drugs (PWID), men who have sex with men (MSM), and transgender individuals; these key populations are particularly vulnerable to HIV acquisition due to a combination of behavioral, biological, and social factors [4]. Key population groups often face structural barriers, including criminalization, stigma, and limited access to healthcare services, which further exacerbates their risk [5]. Among the general population, young adults, particularly women and adolescent girls, are at an elevated risk of acquiring HIV [6]. In sub-Saharan Africa [7], young women are twice as likely as young men to be living with HIV, a disparity driven by gender inequalities, limited access to sexual and reproductive health services, and higher levels of gender-based violence [6]. Addressing these vulnerabilities requires not only medical solutions but also comprehensive strategies that reduce stigma and discrimination while increasing access to care.
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider public health desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Maiya G. Block Ngaybe, Kawoya K. Joseph, Wadana Hamzazai, Carly J. Deal, Stephen Mugamba, Wambi M. Stephen, Richard Muhumuza, Betty Nakaggwa, Auwal Abubakar, Gabriela Valdez, Maia Ingram, John Ehiri, Grace Mirembe, Betty Mwesigwa, Hannah Kibuuka, Purnima Madhivanan. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Strengthened HPV vaccination among adolescents living with HIV, – Findings of a Pilot QI project in Kampala Metropolitan, Uganda
- Evidence brief: Estimating HIV incidence and assessing associated risk factors among adults: Evidence from the 2018–2022 HIV vaccine preparedness cohort in Masaka, Uganda
- Evidence brief: Awareness of and positive attitudes toward HIV pre-exposure prophylaxis among reproductive-aged women in Ghana: A multilevel analysis of the 2022 Demographic and Health Survey
