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Effect of Pre-Exposure Prophylaxis Education on HIV Prevention Practices among Young Adults in Nigeria

Abstract

Human immunodeficiency virus (HIV) infection remains an important public health concern in Nigeria, particularly among populations with increased vulnerability to HIV exposure. Comprehensive HIV prevention requires a combination of evidence-based biomedical, behavioural, and structural approaches. Pre-exposure prophylaxis (PrEP) is an effective biomedical HIV prevention option for people who are HIV-negative and may have an increased risk of acquiring HIV when taken as prescribed. PrEP education provides young adults with information about HIV transmission and prevention, eligibility for PrEP, available PrEP options, effectiveness, safety, adherence, possible side effects, HIV testing requirements, access to PrEP services, and the importance of using PrEP as part of a comprehensive HIV prevention strategy. HIV prevention practices refer to behaviours adopted to reduce the risk of HIV acquisition, including appropriate condom use, HIV testing, reduction of exposure to HIV risk, adherence to prescribed biomedical prevention where indicated, and timely utilization of HIV prevention and sexual health services. In Nigeria, inadequate knowledge of PrEP, misconceptions about its purpose and effectiveness, concerns about side effects, stigma, limited access to services, cost, and misinformation may affect the adoption of appropriate HIV prevention practices among young adults. Effective PrEP education may improve knowledge, correct misconceptions, increase confidence in HIV prevention, and encourage the adoption of appropriate preventive behaviours. Against this background, this study investigates the effect of pre-exposure prophylaxis education on HIV prevention practices among young adults in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and Knowledge-Attitude-Practice framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding young adults' decisions regarding HIV prevention and PrEP. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, behavioural capabilities, and environmental conditions in shaping HIV prevention behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from PrEP education may influence HIV prevention practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how PrEP education may influence HIV prevention practices among young adults in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from young adults in selected communities, educational institutions, and healthcare facilities in Nigeria using a structured anonymous self-administered or interviewer-administered questionnaire, depending on the study setting. A multistage sampling technique will be employed to select states, local government areas, communities or institutions, and eligible young adults. Where feasible, selected participant groups or settings will be assigned to intervention and comparison groups. Participants in the intervention group will receive structured PrEP education covering HIV transmission, HIV prevention, PrEP eligibility, available PrEP options, effectiveness, safety, adherence, potential side effects, HIV testing, access to PrEP services, condom use, and other appropriate HIV prevention strategies. HIV prevention practices will be assessed using indicators such as HIV testing, appropriate condom use, utilization of HIV prevention services, adherence to prescribed PrEP where applicable, reduction of HIV exposure risks, and appropriate use of other evidence-based HIV prevention measures. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, HIV and PrEP knowledge, exposure to education, and HIV prevention practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic or multiple regression analysis, will be used to determine the effect of PrEP education on HIV prevention practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that PrEP education has a significant positive effect on HIV prevention practices among young adults in Nigeria. Young adults exposed to structured PrEP education are expected to demonstrate improved knowledge of HIV prevention and greater adoption of appropriate preventive practices. Education may improve understanding of PrEP eligibility and effectiveness, correct misconceptions, increase awareness of HIV testing and prevention services, strengthen confidence in discussing HIV prevention with healthcare professionals, and encourage appropriate use of PrEP and other preventive measures. However, education alone may not guarantee sustained HIV prevention practices because young adults may continue to face barriers such as stigma, concerns about confidentiality, limited access to PrEP services, cost, misinformation, concerns about side effects, and social or relationship-related influences. Consequently, PrEP education is expected to be most effective when supported by accessible and confidential HIV prevention services, affordable PrEP, regular HIV testing, trained healthcare providers, comprehensive sexual health education, and supportive community environments. The study is expected to contribute to the literature on HIV prevention, PrEP education, biomedical HIV prevention, sexual and reproductive health, health education, young adult health, and public health in Nigeria by providing empirical evidence on the effect of PrEP education on HIV prevention practices among young adults. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Agency for the Control of AIDS (NACA), National Primary Health Care Development Agency (NPHCDA), state ministries of health, HIV prevention programmes, healthcare facilities, sexual and reproductive health professionals, community health workers, development partners, and policymakers regarding strategies for strengthening HIV prevention among young adults. The study will also provide evidence-based recommendations for improving PrEP education, expanding access to confidential HIV prevention services, addressing misconceptions and stigma, strengthening HIV testing and counselling, improving adherence support, and promoting comprehensive HIV prevention practices among young adults across Nigeria.

Keywords: Pre-exposure prophylaxis education, PrEP education, HIV prevention practices, young adults, HIV prevention, HIV, biomedical prevention, sexual and reproductive health, health education, HIV testing, PrEP, public health, Nigeria.