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

Abstract

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.

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

“…20 Contrary to our findings, results from other studies done in Brazil, Tanzania, central Uganda, Kenya, Ghana, and China, reported significantly lower prevalence rates of PrEP use among female sex workers, ranging from 1.4 to 11%. 16,[21][22][23][24][25] The difference in prevalence rates could be attributed to various factors, including differences in sample size, geographical location, cultural norms, access to healthcare services, and the promotion of PrEP initiatives in the diverse settings.…”

Awareness and Willingness to use Condoms and Preexposure Prophylaxis among Gay, Bisexual, and Other Cisgendered Men who Have sex with men in Slum Communities in Ghana. BSGH-004

“…Among many interventional strategies to prevent the spread of HIV, administering preexposure prophylaxis (PrEP) has been identified as a practical way to reduce incidence. [20][21][22] PrEP can be presented as a daily medication to prevent a diagnosed HIV-negative person from getting infected. 23 PrEP is the use of antiretrovirals in individuals who do not have HIV to prevent infection.…”

“…37,38 The uptake of antiretrovirals as an effective means of preventing the spread of HIV is reported to be globally low. 20,[39][40][41] Many other barriers to PrEP implementation and antiretroviral usage are seen in the stigma surrounding its use among individuals at increased risk of HIV, the possible drug-to-drug interaction, the risk of sexually transmitted infection, the cost of antiretrovirals, and its reported side effects. [41][42][43] Additionally, the cost of antiretrovirals has been shown to significantly affect PrEP implementation among key Ghanaian population.…”

“…[47][48][49] In Ghana, available research indicates that PrEP rejection is high among individuals at an increased risk of infection. 20 According to Dako-Gyeke et al 50 and Kumar et al 51 , MSM in Ghana form a significant population (17.5%) of people living with HIV in the country and have a higher chance of not getting tested or engaging in HIV-related in treatment. These studies highlight an increasing need for MSM to explore preventive strategies when engaged in activities that increase their risk of infection.…”

"We have our reasons": Exploring the acceptability of pre-exposure prophylaxis among gay, bisexual, and other men who have sex with men in Ghana

“…This proactive step paved the way for the commencement of PrEP services to key populations a year later, in August 2020, with a particular emphasis on MSM (13). Research conducted in Ghana before the rollout of PrEP consistently indicated that a lack of awareness and knowledge among Ghanaian MSM was a significant barrier to PrEP's acceptance (14,15).…”