# Pre-exposure prophylaxis in Guyana: linking key populations and other vulnerable groups

## TL;DR

This study in Guyana finds low PrEP usage despite moderate awareness, with barriers like poor access and fear of side effects, and a strong preference for injectable PrEP options.

## Contribution

The study identifies specific barriers to PrEP uptake in Guyana and proposes targeted strategies to improve access and usage among vulnerable populations.

## Key findings

- Only 18% of participants were ever offered PrEP by healthcare providers, and none were active users.
- Participants showed a strong preference (79%) for long-acting injectable PrEP options.
- High willingness (74%) to recommend PrEP to peers indicates potential for peer advocacy.

## Abstract

•Moderate pre-exposure prophylaxis (PrEP) awareness (59%) but zero current usage among participants.•Limited provider engagement—only 18% were ever offered PrEP services.•Main barriers: poor access (48%) and fear of side effects (27%).•Strong preference (79%) for long-acting injectable PrEP options.•High willingness to recommend PrEP (74%), showing strong advocacy potential.

Moderate pre-exposure prophylaxis (PrEP) awareness (59%) but zero current usage among participants.

Limited provider engagement—only 18% were ever offered PrEP services.

Main barriers: poor access (48%) and fear of side effects (27%).

Strong preference (79%) for long-acting injectable PrEP options.

High willingness to recommend PrEP (74%), showing strong advocacy potential.

Despite the introduction of pre-exposure prophylaxis (PrEP) in Guyana as an effective HIV prevention tool, its uptake remains low among key and vulnerable populations, such as men who have sex with men, sex workers, and transgender individuals. This study assessed awareness, uptake, and barriers to PrEP among seronegative individuals in Guyana and proposed strategies to improve accessibility and use.

A cross-sectional, mixed-method study was conducted among 90 seronegative adults across Regions 3, 4, 6, and 10. Quantitative data were collected via structured questionnaires, whereas qualitative insights were gathered through interviews and focus group discussions. Statistical analyses (chi-square) and thematic coding were applied.

Among participants, 59% were aware of PrEP, primarily through media sources (43%), whereas only 18% had ever been offered PrEP by a health care provider. None of the participants were active users. The key barriers identified were limited access (48%), fear of side effects (27%), and inadequate provider engagement. However, 57% expressed willingness to use PrEP and 74% would recommend it to peers.

PrEP awareness in Guyana is moderate but constrained by systemic barriers, misinformation, and health care inaccessibility. Strengthening provider training, integrating PrEP into routine services, and community outreach are essential to improve uptake.