Adherence to oral HIV pre-exposure prophylaxis among female sex workers in Kampala, Uganda

Nalukwago, Grace Kakoola; Isunju, John Bosco; Muwonge, Timothy; Katairo, Thomas; Bunani, Nelson; Semitala, Fred C.; Kyambadde, Peter; Matovu, Flavia

doi:10.4314/ahs.v21i3.12

Cited by 6 publications

(6 citation statements)

References 19 publications

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“…Our study found that the overall PrEP adherence among FSWs was 48.3%, which was lower than that observed in other countries. [18,22] The present study found that living with family, pill packaging, and perception of PrEP were associated with adherence.…”

Section: Discussionmentioning

confidence: 50%

“…The sample size of FSWs included in the present study to determine adherence to oral HIV PrEP was calculated based on the level of adherence to oral HIV PrEP among FSWs in Kampala, Uganda, which was 71%. [18] The sample size was estimated using the Kish-Leslie formula (1965) as follows: [19] Sample Size…”

Section: Sample Size Calculationmentioning

confidence: 99%

“…where N = minimum sample size; Z = confidence interval (CI) level at 95% (CI = 1.96); P is the proportion of PrEP adherence among FSWs based on a previous study conducted in Kampala, Uganda 71% [18] ; and d = 5% margin of error (standard value = 0.05). The sample size was calculated as follows:…”

Section: Sample Size Calculationmentioning

confidence: 99%

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Factors associated with adherence to oral HIV pre-exposure prophylaxis among female sex workers in the Mara Region, Tanzania: A 2022 cross-sectional study

Churu,

Kulemba,

Kapesa

et al. 2023

Medicine

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Female sex workers (FSWs) have a higher risk of acquiring human immunodeficiency virus (HIV) infection compared with the general female population. Tanzania adopted pre-exposure prophylaxis (PrEP) use for HIV-negative key populations in 2019 as a strategy to reduce HIV transmission. We aimed to identify factors associated with PrEP adherence among FSWs in Tanzania. We conducted a cross-sectional study of FSWs using oral HIV PrEP from June-July 2022 in 5 Mara Region districts. Stata software was used to analyze the quantitative data. Poor overall PrEP adherence was observed among FSWs, with adherence of 48.3% (174/360) and 43.3% (156/360) according to pill count and self-reports, respectively. Participants living with family members had 2.32 higher odds of PrEP adherence (adjusted odds ratio [aOR] = 2.32, 95% confidence interval [CI] = 1.27–42.23, P = .006) versus participants living alone or with friends. Moreover, FSWs who preferred pill packages had 1.41 higher odds of adherence (aOR = 2.43, [95% CI = 1.41–4.19, P = .001]); participants with a good perception of PrEP had 1.71 higher odds (aOR = 1.71, [95% CI = 1.01–2.91, P = .047]) of PrEP adherence. We found that living with family, pill packaging, and PrEP perception played significant roles in PrEP adherence among FSWs. Interventions to improve pill packaging, social support, and the perception of PrEP among FSWs should be intensified to increase adherence in this vulnerable population.

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Section: Discussionmentioning

confidence: 50%

Section: Sample Size Calculationmentioning

confidence: 99%

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Factors associated with adherence to oral HIV pre-exposure prophylaxis among female sex workers in the Mara Region, Tanzania: A 2022 cross-sectional study

Churu,

Kulemba,

Kapesa

et al. 2023

Medicine

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“… 29 Furthermore, interventions such as PrEP adherence support groups that meet physically or online via WhatsApp have been set up for female sex workers in Uganda to improve adherence for those on PrEP to offer social support to each other. 30 However, our findings also highlight the need to address the economic and social barriers that may prevent female sex workers from accessing HIV prevention services. A recent study in Mexico identified financial constraints and social stigma as some of the barriers to PrEP use among female sex workers.…”

Section: Discussionmentioning

confidence: 78%

Pre-exposure prophylaxis use among female sex workers in Gulu city, Uganda: a community-based cross-sectional study

Bongomin,

Kibone,

Okot

et al. 2023

Therapeutic Advances in Infection

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Background: Pre-exposure prophylaxis (PrEP) is an important intervention for reducing the risk of HIV transmission among high-risk populations such as female sex workers in Africa, where HIV prevalence remains high. We aimed to assess the use of PrEP among female sex workers in Gulu, Uganda. Methods: In this community-based cross-sectional study, we included HIV-negative female sex workers purposely selected from hotspots within Gulu city, Uganda between February and March 2023. A semi-structured questionnaire was administered to collect data on sociodemographic characteristics, reproductive data, sexual practices, and self-reported PrEP use in the past 3 months. Symptoms of depression were screened using Patient Health Questionnaire-2 tool. Predictors of PrEP use was determined using modified Poisson regression analysis model. p < 0.05 was considered statistically significant. Results: We enrolled 273 female sex workers with a median age of 27 (interquartile range: 24–32) years. Overall, 181 (66.3%) participants used PrEP. PrEP use was associated with; regular source of income beside sex work [adjusted prevalence ratio (aPR): 3.7, 95% confidence interval (CI): 2.11–6.35, p < 0.001], being in a polygamous marriage (aPR: 6.9, 95% CI: 1.32–35.77, p = 0.022), practicing sex work in both rural and urban areas (aPR: 2.5, 95% CI: 1.49–4.35, p < 0.001), having symptoms of depression (aPR: 3.3, 95% CI: 1.43–7.74, p = 0.005), and use of postexposure prophylaxis (PEP) in the past 12 months (aPR: 0.31, 95% CI: 0.17–0.59, p < 0.001). Conclusion: Almost two in three of the female sex workers in Gulu city were currently using PrEP. Previous use of PEP was associated with lower use of PrEP. These findings suggest the need for targeted interventions to increase PrEP uptake and decrease HIV acquisition in this high-risk population among female sex workers, especially those with low income and limited access to healthcare.

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“…in the study showed that high LTFU to PrEP has been found among PrEP user who didn’t use contraception methods. We can therefore see a link between lost follow up and contraceptive use and therefore intensified contraceptive counseling and screening before PrEP initiation and during PrEP use may improve PrEP adherence among users (25).…”

Section: Discussionmentioning

confidence: 99%

Incidence and Determinants of loss to follow-up of HIV pre-exposure prophylaxis among key and priority population groups in Addis Ababa health centers, Ethiopia retrospective cohort study

Aragaw,

Taddse

2023

Preprint

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Background- ‘loss of follow-up’ is a significant public health concern globally. Retention in preventive care among at-risk key and priority population groups is critical for the successful prevention of HIV acquisition. Loss to follow-up of individuals has countless negative impacts on HIV prevention outcomes. There is, however, limited information about the incidence and predictors of loss to follow-up in the study area. Thus, this study aimed to determine the incidence rate and predictors of loss to follow-up among Prep users.Method- A retrospective cohort study was undertaken using 240 PrEP users between May 2020, and May 26, 2022, at Addis Ababa selected health centers. All eligible clients who fulfilled the inclusion criteria were included in study.Results and discussionA total of 240 participants with a median age of 32.0 years (interquartile range [IQR]: 27.0 to 40.0) had a median time since initiation of PrEP 21.2 months (IQR: 6.5 to 22.1). Almost half 122 (50.8%) were married, single 58 (24.2%), divorced 10 (4.2%), and widowed 50 (20.8%). One third were female sex workers (33.3%), and the rest (66.7%) were sero-discordant couples. Most of the users were from ART clinics (60.8%) and (39.2%) were from PMTCT clinics Being male is associated with 1.77 times in risk of getting lost than female (ARR=1.77, 95% CI =1.12-2.79). those who had no adherence counseling was associated with 1.86 times in the chance of LTFU as compared to those who had have adherence counseling (ARR=1.863, 95% CI =1.184, 2.930, P-value=0.003). 86 (35.8%) experienced loss to follow-up and the overall incidence rate of loss to follow-up was 7.3 (95% CI: 4.3-12.6) per 100 person-years of observation (PYs). PrEP adherence strategies should be developed and designed as a holistic approach, acknowledging the contextual factors of key population groups.Conclusion- About 35.8% clients became LTFU of PrEP with overall incidence of 7.3(4.3-12.6) per 100 pys observation. Research preparedness involving key and priority population groups should be strengthened for HIV prevention intervention evaluations in Ethiopia.

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Adherence to oral HIV pre-exposure prophylaxis among female sex workers in Kampala, Uganda

Cited by 6 publications

References 19 publications

Factors associated with adherence to oral HIV pre-exposure prophylaxis among female sex workers in the Mara Region, Tanzania: A 2022 cross-sectional study

Factors associated with adherence to oral HIV pre-exposure prophylaxis among female sex workers in the Mara Region, Tanzania: A 2022 cross-sectional study

Pre-exposure prophylaxis use among female sex workers in Gulu city, Uganda: a community-based cross-sectional study

Incidence and Determinants of loss to follow-up of HIV pre-exposure prophylaxis among key and priority population groups in Addis Ababa health centers, Ethiopia retrospective cohort study

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