Adherence Counselling and Uptake/Retention to Prep Among Key Population in Lafia Local Government Area, Nasarawa State, Nigeria

Abstract

Though Pre-exposure Prophylaxis (PrEP) is clinically effective, failure to optimally adhere to the regimen is a major obstacle to protective results. This study examined the effect of adherence counselling on PrEP uptake and retention among key populations in Lafia Local Government Area. The study was anchored on the Health Belief Model (HBM). The study adopted a cross-sectional research design. A sample of 357 respondents, comprising female sex workers,gay who have sex with men and people who inject drugs, were surveyed, complemented by 6 in-depth interviews with key informants. Quantitative data were analyzed using descriptive statistics and multiple regression analysis with the help of SPSS version 26. The findings revealed an R of .362 and R² of .131, indicating that counselling-related variables explain 13.1% of the variance in PrEP adherence behavior (F = 11.528; p < .000). Specifically, addressing clients’ concerns during sessions (B = 0.273, p = .000) and accessibility of counselling (B = –0.131, p = .003) were significant predictors of retention. Descriptive results showed that 78.7% of respondents always take PrEP as prescribed. The Qualitative result shows that phone alarms, peer follow-ups and emotional reassurance effectively bridge the gap between initial uptake and long-term retention. The study concludes that structured counselling is a fundamental driver of PrEP success, suggesting that biomedical delivery must be supported by a client-centered psychosocial framework. The Recommendations include prioritizing side-effect management in sessions, improving service accessibility through flexible outreach, and formalizing personalized risk assessment tools to enhance self-perceived vulnerability and preventive commitment.