Acceptability and willingness of HIV pre-exposure prophylaxis amongst female sex workers in China

Poon, Adrienne N; Han, Lifeng; Li, Zhijun; Zhou, Chu; Li, Yan; Huang, Lu; Liao, Meizhen; Shepard, Colin W.; Bulterys, Marc

doi:10.1080/09540121.2019.1612001

Cited by 14 publications

(12 citation statements)

References 29 publications

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“…At baseline, HIV prevalence in this cohort was 41%, condom use was low, and GBV and alcohol use were common, 33 which highlights the urgent priority for prevention services such as PrEP to be integrated into a comprehensive approach to addressing HIV in this population. However, FSW in this study were overwhelmingly unaware of PrEP, echoing findings from other settings in which awareness of PrEP among FSW was low, 36 37 and highlighting the critical first step of ensuring sex workers are informed and empowered to make decisions around PrEP and whether it may be a good option for them. The Global Network of Sex Work Projects has called for strengthening the capacity of sex worker organisations in educating their communities on PrEP in order to ensure that sex workers have access to accurate knowledge and information and these findings only further underscore this point.…”

Section: Discussionsupporting

confidence: 53%

Acceptability of multiple modalities of pre-exposure prophylaxis (PrEP) among female sex workers in Tanzania: a mixed-methods study

Beckham

Mantsios²,

Galai

et al. 2022

BMJ Open

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ObjectivesModalities of pre-exposure prophylaxis (PrEP) for HIV prevention offer options to women at high risk including female sex workers (FSW). This study aimed to explore FSW’s acceptability and preferences for oral pills, long-acting (LA) injectable and vaginal ring PrEP.DesignSequential, explanatory, mixed methods.SettingIringa, Tanzania.ParticipantsFSW aged above 18 were recruited from sex work venues using time-location sampling (n=496); HIV-uninfected (n=293) were included in this analysis. Subsequently, survey participants were recruited for in-depth interviews (n=10) and two focus group discussions (n=20).Primary outcome measures(1) Acceptability of PrEP (Do you personally think it would be worth it to you to take ART if it could prevent HIV?: yes/no) and (2) preference for LA injectable versus oral pills (If you personally were going to take ART to prevent HIV infection, would you prefer to take it in the form of a daily pill or an injection once every 3 months? Injection/pill).ResultsParticipants were (92%) unaware of PrEP but 58% thought it would be worth it to personally take PrEP. Acceptability of PrEP was significantly associated with higher social cohesion (aOR 2.12; 95% CI 1.29 to 3.50) and STI symptoms in the past 6 months (aOR 2.52; 95% CI 1.38 to 4.62). Most (88%) preferred LA vs oral PrEP. Qualitative findings revealed generally positive reactions to all types of PrEP, and they were viewed as a welcome backup to condoms. Participants had concerns about pills (burden of daily use, stigma from clients), and the vaginal ring (fear of client noticing and becoming suspicious, fear of infertility) and overall preferred LA-PrEP (less frequent use, easy to hide, belief in higher efficacy).ConclusionsOffering multiple formulations of PrEP within the context of community-driven HIV prevention interventions among FSW may facilitate increased uptake and adherence. LA injectable PrEP may be a particularly preferred formulation among FSW.Trial registration numberNCT02281578.

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Section: Discussionsupporting

confidence: 53%

Acceptability of multiple modalities of pre-exposure prophylaxis (PrEP) among female sex workers in Tanzania: a mixed-methods study

Beckham

Mantsios²,

Galai

et al. 2022

BMJ Open

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“…Moreover, the drug users included in the survey were drug users from the high-risk population in MSM, FSWs, and HIV-serodiscordant couples. The MSM often had multiple sexual partners and more unprotected anal sex 84 ; FSWs are characterized by high mobility, strong concealment, high incidence of high-risk behaviors, 36 and HIV-serodiscordant couples having high exposure risk, high condom utilization rate, and intense awareness of prevention 85, 86 ; so their acceptance of PrEP is moderate. Therefore, drug users from the high-risk population are often influenced by the dual risk factors of sexual behavior and drug use; based on a single population, they have a higher evaluation of their own risk of HIV infection and are more influenced by their peers, which may be the reasons for their higher acceptance.…”

Section: Discussionmentioning

confidence: 99%

Acceptability of HIV pre-exposure prophylaxis in China: A systematic review and meta-analysis

et al. 2022

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Using pre-exposure prophylaxis (PrEP) for the prevention of HIV infection is a popular, contemporary research topic. We retrieved PubMed, Web of Science, MEDLINE, Wanfang, CNKI, and Sinomed databases, and related websites to identify studies both in Chinese and English, which reported the acceptability of PrEP in China. A total of 3203 citations were retrieved, of which 54 were included. We found that the acceptability varied widely across the country, ranging from 19.1% to 94.6%, and the pooled estimate was 66.8% (95% CI: 62.0%–71.3%). Higher acceptability of PrEP was associated with the following factors: individuals with a lower educational degree, higher income, non-discriminatory attitude towards AIDS or AIDS patients, self-perceived high HIV risk, feeling that PrEP should be promoted, familiarity with PrEP, history of HIV testing, history of anal intercourse, consistent condom use, higher number of sexual partners. The main reasons for not using PrEP are doubting its validity, fear of potential side effects and financial burden, and fear of stigma for using PrEP. This review found that the acceptance in China was moderate.

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“…[15][16][17] This is attributable to poor knowledge and understanding of the risk and prevention of HIV and AIDS. [15] Studies reported in some African countries and other regions on PrEP interest among female bar workers show a very low level of awareness or knowledge of PrEP among FSW, these include Dar es Salaam (5%), Guangxi, China (15.1%), and Baltimore (21%). [18][19][20] A number of factors have been identified in literature as possible barriers to PrEP uptake, these are; drug security, possible drug-drug interaction, increased risk of other sexually transmitted diseases, pregnancy among FSW, stigma, effectiveness and cost, reduced risk perception, concerns about effectiveness of PrEP and side effects all affects the willingness to take PrEP.…”

Section: Introductionmentioning

confidence: 99%

Willingness to take and ever use of pre-exposure prophylaxis among female sex workers in Ghana

Guure¹,

Afagbedzi²,

Torpey

2022

Medicine

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Pre-exposure prophylaxis (PrEP) is a drug taken by people who are human immunodeficiency virus (HIV) negative and at increased risk of acquiring HIV. It's an effective intervention for HIV prevention. This study seeks to report on the prevalence and determinants of willingness to take and ever use of PrEP among female sex workers (FSW) in Ghana.The data analyzed was obtained from the Integrated Bio-behavioral Surveillance Survey conducted across the 16 regions of Ghana in 2020. Analysis was only performed on FSW who were tested negative to HIV and were sexually active. All included variables were described using medians, percentages, and graphs. Bayesian adjusted odds ratios and 95% credible intervals were estimated using a Bayesian generalized linear model via the binomial family of distributions under the logit link function.Of the 5107 FSW with complete data on willingness to use PrEP, 2737 (53.59%) reported their willingness to take PrEP. Out of the 998 respondents who have ever heard of PrEP only 64 (6.39%) have ever used PrEP. The median age of the respondents was 25 years. People with no comprehensive knowledge of HIV and acquired immunodeficiency syndrome as well as those who entered into the FSW business at age less than 25 years; 946 (34.56%) and 2181 (79.65%) respectively were more willing to take PrEP. FSW from 6 out of the 16 regions of Ghana have never used PrEP. A statistically significant difference between those who entered the sex work at age less than 25 years and those within 25 to 34 years was observed. About 23% of FSWs who had been screened for Sexually Transmitted Infections were more likely to take PrEP.Respondents with lesser age and no comprehensive knowledge of HIV were more willing to take PrEP. The willingness to accept PrEP among FSWs in Ghana is modest. However, utilization is low. Advocacy or intervention programs are required to improve uptake of PrEP.

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Acceptability and willingness of HIV pre-exposure prophylaxis amongst female sex workers in China

Cited by 14 publications

References 29 publications

Acceptability of multiple modalities of pre-exposure prophylaxis (PrEP) among female sex workers in Tanzania: a mixed-methods study

Acceptability of multiple modalities of pre-exposure prophylaxis (PrEP) among female sex workers in Tanzania: a mixed-methods study

Acceptability of HIV pre-exposure prophylaxis in China: A systematic review and meta-analysis

Willingness to take and ever use of pre-exposure prophylaxis among female sex workers in Ghana

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