Date of Award

January 2026

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Onyema Ogbuagu

Abstract

AbstractA Questionnaire Assessing Attitudes And Readiness For HIV Pre-Exposure Prophylaxis Therapy For Community Members At-Risk For HIV Acquisition In Liberia Yishak Bedaso;1 Jessica Tuan, MD, MS;2 Yassah M. Barclay-Korboi;3 Onyema Ogbuagu MBBCh, FACP, FIDSA4 Affiliation: 1. Yale School of Medicine, New Haven, CT, USA 2. Columbia University Vagelos College of Physicians and Surgeons, Department of Infectious Diseases, New York, NY, USA 3. JFK Memorial Hospital, Monrovia, Liberia. 4.Yale Antivirals & Vaccines Research Program, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA; Despite how effective Pre-exposure prophylaxis (PrEP) is in preventing HIV, uptake among women in sub-Saharan Africa remains limited. Liberia is uniquely vulnerable given a high HIV burden and poor political and economic circumstances. Much of the existing literature focuses on Southern and Easter Africa and often neglects young women, leaving a gap in understanding barriers to PrEP access and willingness to use PrEP among women in Liberia. This cross-sectional study analyzed survey data collected from women receiving care at a tertiary hospital in Monrovia, Liberia. A 151-tem questionnaire assessed sociodemographic characteristics, HIV knowledge, perceived risk, stigma, and structural barriers to care. The primary outcome was willingness to initiate PrEP. Logistic regression models were used to look at the associations between participant characteristics and willingness to use PrEP. A majority of participants expressing willingness to use PrEP (90.1%). In univariate analyses, cost concern was the only significant univariate predictor (OR 4.31, p=0.026). Participants who reported concern about the cost of PrEP had significantly higher odds of reporting willingness to initiate PrEP compared to those without cost concern. In addition, higher HIV knowledge was significantly associated with lower odds of belief that others would think less of them for taking PrEP (OR.33, 95% CI 0.12-0.93, p = 0.036). Sociodemographic variables such as age, education, employment status did not show association with willingness. While concerns related to HIV stigma were present, finding suggest that cost, and social perception and HIV knowledge play an important role in shaping preventative health behaviors. Willingness to use PrEP among women in this sample was influenced by cost alone and was not affected by demographic factors. However, increased HIV knowledge was linked with decreased negative stigma perception, therefore, in addition to reducing structural barriers, interventions aimed at increasing PrEP uptake should prioritize improving HIV risk awareness and addressing community level social perceptions and stigma. This study further highlights the importance of context specific strategies to support HIV prevention among women in Liberia who are a high-risk population.

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