scholarly journals Understanding issues around use of oral pre exposure prophylaxis among female sex workers in India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Seema Sahay ◽  
Archana Verma ◽  
Suhas Shewale ◽  
Sampada Bangar ◽  
Athokpam Bijeshkumar ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Thematic Analysis ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Theory Approach ◽  
Female Sex ◽  
Long Acting ◽  
Willingness To Use ◽  
Exposure Prophylaxis ◽  
Oral Prep

Abstract Background Empowering female sex workers (FSWs) through women controlled HIV prevention option has been in focus globally. FSWs are important target for oral pre exposure prophylaxis (PrEP). A multi-centric qualitative study was conducted to explore the FSWs’ willingness to use oral PrEP in India. Methods Seventy three interviews and 02 focus group discussions were conducted at 3 high HIV prevalent states in India during 2013–14. Study explored issues around willingness to use oral PrEP. The study was approved by the respective institutional ethics committee of the study sites. Thematic analysis using grounded theory approach was used to analyze the data in N-VIVO version 8.0. Results Thematic analysis showed events of forced condom-less sex. FSWs believed that oral PrEP could provide independence, financial gains, and privacy and therefore hoped to use it as an alternative to male condom. However, any impact on physical/ aesthetic attributes and reproductive system were not acceptable and could become a barrier. Provider initiated oral PrEP was not preferred. Providers voiced safety monitoring concerns. Adherence emerged as a challenge because of: (1) alcohol use; (2) taking PrEP tablet each day being boring; (3) Stigma because Oral PrEP is ARV based. Alcohol use and dread of repetitive dose brings forth the need for long acting oral PrEP. Conclusion Oral PrEP is acceptable among FSWs; it should be rolled out alongside strong messages on STI protection and PrEP as compliment to condoms. PrEP roll out requires educating communities about HIV treatment versus prevention. Long-acting oral PrEP could address both ‘boredom’ and alcoholism and sustain adherence.

scholarly journals Understanding Issues Around Use of Oral Pre-Exposure Prophylaxis Among Female Sex Workers in India.

2021 ◽  
Author(s):  
Seema Sahay ◽  
Archana Verma ◽  
Suhas Shewale ◽  
Sampada Dipak Bangar ◽  
Athokpam Bijeshkumar ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Hiv Treatment ◽  
Theory Approach ◽  
Female Sex ◽  
Long Acting ◽  
Willingness To Use ◽  
Exposure Prophylaxis ◽  
Oral Prep

Abstract BackgroundEmpowering female sex workers (FSWs) through women controlled HIV prevention option has been in focus globally. FSWs are important target for oral PrEP (Pre Exposure Prophylaxis). A multi-centric qualitative study was conducted to explore the FSWs’ willingness to use oral PrEP in India.MethodsSeventy three qualitative interviews and 02 focus group discussions were conducted at 3 high HIV prevalent states in India during 2013-14. Study explored issues around willingness to use oral PrEP. The study was approved by the respective institutional ethics committee of the study sites. Thematic analysis using grounded theory approach was used to analyze the data in N-VIVO version 8.0. ResultsThematic analysis showed events of forced condom-less sex. FSW believed that oral PrEP could provide independence, financial gains, and privacy and therefore hoped to use it as an alternative to male condom. However, any impact on physical/ aesthetic attributes and reproductive system were not acceptable and could become a barrier. Provider initiated oral PrEP was not preferred. Providers voiced safety monitoring concerns. Adherence emerged as a challenge because of: 1) alcohol use; 2) taking PrEP tablet each day being too mundane; 3) Stigma because Oral PrEP is ARV based. Alcohol use and dread of repetitive dose brings forth the need for long acting oral PrEP. ConclusionOral PrEP is acceptable among FSWs; it should be rolled out alongside strong messages on STI protection and PrEP as compliment to condoms. PrEP roll out requires educating communities about HIV treatment versus prevention. Long-acting oral PrEP could address both ‘mundane’ and alcoholism and sustain adherence.

scholarly journals Oral PrEP: Is it only a pill to be swallowed: a qualitative study among female sex workers in India

2020 ◽  
Author(s):  
Seema Sahay ◽  
Archana Verma ◽  
Suhas Shewale ◽  
Sampada Dhayarkar ◽  
Athokpam Bijeshkumar ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Qualitative Study ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Theory Approach ◽  
Care Providers ◽  
Targeted Interventions ◽  
Female Sex ◽  
Willingness To Use ◽  
Oral Prep

Abstract Background Empowering female sex workers (FSWs) through women controlled HIV prevention option has been in focus globally. The success of targeted interventions among FSWs indicates that this population could become an important and feasible target for oral PrEP (Pre Exposure Prophylaxis). A qualitative study was conducted to study FSWs’ willingness to use oral PrEP in India.Methods In-depth interviews (n=39) and two focus group discussions (n=14) were conducted at 3 high HIV prevalence urban and rural sites in India among FSWs. Key informant interviews (n=34) were conducted with a bisexual man, 6 brothel keepers and 27 Health Care Providers (HCPs). The study explored issues around willingness to use oral PrEP. The study was approved by the respective institutional ethics committee of the study sites. Thematic analysis using the grounded theory approach was used to analyze the data in N-VIVO version 8.0. Results FSWs were willing to use daily oral PrEP and hoped to use it as an alternative to the male condom. One of the emerging themes showed that the situations of condom-less sex over which FSWs had no control. This made them desire oral PrEP which was easy to use and geared to provide independence, financial gains, and privacy. HCP initiated oral PrEP was not acceptable. However, HCPs pointed out safety monitoring needs. For FSWs, safety concerns pertained to their own physical/ aesthetic attributes and reproductive system in a major way. Adherence emerged as a challenge because of: 1) FSWs’ prevalent habit and need of alcohol use; 2) their notion of daily dosing being too mundane; 3) Stigma because Oral PrEP is ARV based. Alcohol use and dread of repetitive dose bring forth the need for long-acting oral PrEP. Conclusion Oral PrEP is acceptable among FSWs; it should be rolled out alongside strong messages on STI protection given the perceptions of FSWs that oral PrEP might replace condoms. Education about ARV-based oral PrEP needs to be spelled to prevent stigma. Adherence counseling should take cognizance of FSWs’ lifestyle, specifically making oral PrEP less of a mundane task.

scholarly journals Oral and vaginal HIV pre-exposure prophylaxis product attribute preferences among female sex workers in the Mexico-US border region

2018 ◽  
Vol 30 (1) ◽  
pp. 45-55 ◽  
Author(s):  
HA Pines ◽  
SA Strathdee ◽  
CW Hendrix ◽  
CC Bristow ◽  
A Harvey-Vera ◽  
...  
Keyword(s):  
Sex Workers ◽  
Female Sex Workers ◽  
Border Region ◽  
Ciudad Juarez ◽  
Product Attributes ◽  
Female Sex ◽  
Frequency Of Use ◽  
Vaginal Gels ◽  
Willingness To Use ◽  
Exposure Prophylaxis

To assess the potential uptake of HIV pre-exposure prophylaxis (PrEP) products among female sex workers (FSWs) vulnerable to HIV infection, we examined the influence of product attributes on willingness to use products among 271 HIV-negative FSWs in Tijuana and Ciudad Juarez, Mexico (2016–2017). Via five-point Likert scale ratings, participants indicated their willingness to use hypothetical products with six attributes: formulation (pill, gel, liquid, or ring), frequency of use (daily, on-demand, or monthly), cost per use (10 or 200 pesos), effectiveness (40% or 80%), side effects (none or mild), and access point (healthcare clinic or non-governmental organization). Conjoint analysis was used to determine the impact of attributes on product ratings and identify preferred product attributes. Multinomial logistic regression was used to identify factors associated with formulation preferences. In both cities, formulation and frequency of use had the greatest impact on ratings. Participants in Ciudad Juarez indicated a strong preference for oral pills, whereas participants in Tijuana indicated roughly equal preferences for oral pills and vaginal gels. Monthly product use was preferred in both cities. Compared to preferring oral pills (38%), preferring vaginal gels (28%) was associated with practicing vaginal lubrication (adjusted odds ratio = 2.08; 95% confidence interval: 1.07–4.04). Oral PrEP may be acceptable to many FSWs in Tijuana and Ciudad Juarez; however, continued development of behaviorally-congruent vaginal PrEP products may also facilitate uptake and ensure sufficient coverage.

Predictors of willingness to use HIV pre-exposure prophylaxis among female sex workers in Southwest China

AIDS Care ◽  
2012 ◽  
Vol 25 (5) ◽  
pp. 601-605 ◽  
Author(s):  
Todd Jackson ◽  
Ailong Huang ◽  
Hong Chen ◽  
Xiao Gao ◽  
Yan Zhang ◽  
...  
Keyword(s):  
Sex Workers ◽  
Female Sex Workers ◽  
Southwest China ◽  
Female Sex ◽  
Willingness To Use ◽  
Exposure Prophylaxis

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

2021 ◽  
Vol 21 (3) ◽  
pp. 1048-1058
Author(s):  
Grace Kakoola Nalukwago ◽  
John Bosco Isunju ◽  
Timothy Muwonge ◽  
Thomas Katairo ◽  
Nelson Bunani ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Hiv Prevention Intervention ◽  
Female Sex ◽  
Exposure Prophylaxis ◽  
Oral Prep

Introduction: In Kampala Uganda, female sex workers (FSWs) have high HIV prevalence (33%). Oral PrEP is a novel HIV prevention intervention that offers hope to decrease HIV incidence in key populations especially among FSWs. Studies have shown that with poor adherence, oral PrEP has no efficacy, and therefore adherence to PrEP is critical among FSWs to maximize HIV prevention. However, implementation data on adherence to PrEP among FSWs is limited so this study sought to assess adherence to PrEP. Specifically, we sought to 1) determine the level of adherence to PrEP among FSWs, and 2) determine factors associated with PrEP adherence. Methods: This cross-sectional study was conducted from November to December 2018; 126 FSWs using PrEP were inter- viewed using a questionnaire. Adherence was categorically defined as high adherence and low adherence. Logistic regression was done. Results: Using long-term contraception methods (OR 0.06, 95% CI: 0.04-0.77) and not using condoms with clients (OR 0.07, 95% CI: 0.01-0.42) were negatively associated with high PrEP adherence. Conclusion: Barriers to PrEP adherence need to be addressed for successful PrEP implementation to improve adherence going forward. Service care providers should reinforce positive behaviors such as use of condoms devotedly during PrEP breaks. Keywords: Oral PrEP; adherence; female sex workers.

Motivating factors associated with oral pre-exposure prophylaxis use among female sex workers in South Africa

2022 ◽  
pp. 135910532110726
Author(s):  
Nosipho Faith Makhakhe ◽  
Anna MeyerWeitz ◽  
Yvonne Sliep
Keyword(s):  
Sex Workers ◽  
Female Sex Workers ◽  
Motivating Factors ◽  
Peer Educators ◽  
Behavioral Strategies ◽  
Factors Associated ◽  
Future Aspirations ◽  
Female Sex ◽  
Exposure Prophylaxis ◽  
Oral Prep

To explore the motivating factors that encourage female sex workers to take oral PrEP, despite the challenges that come with adherence. The 39 participants in this study consisted of female sex workers, peer educators, a counselor, and a researcher. Participants took PrEP as an expression of self-love. Some participants described PrEP as empowering because they could independently prevent HIV. They were also motivated by parenting, hope and future aspirations. It is important for future PrEP interventions to incorporate behavioral strategies that appeal to the user’s personal and deeper motivations for living.

scholarly journals Lifetime and past-month substance use and injection among street-based female sex workers in Iran

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Payam Roshanfekr ◽  
Mehrdad Khezri ◽  
Salah Eddin Karimi ◽  
Meroe Vameghi ◽  
Delaram Ali ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Drug Use ◽  
Injection Drug Use ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Injection Drug ◽  
Logistic Regression Models ◽  
Female Sex ◽  
History Of ◽  
Group Sex

Abstract Background Street-based female sex workers (FSWs) are highly at risk of HIV and other harms associated with sex work. We assessed the prevalence of non-injection and injection drug use and their associated factors among street-based FSWs in Iran. Methods We recruited 898 FSWs from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Correlates of lifetime and past-month non-injection and injection drug use were assessed through multivariable logistic regression models. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were reported. Results Lifetime and past-month non-injection drug use were reported by 60.3% (95% CI 51, 84) and 47.2% (95% CI 38, 67) of FSWs, respectively. The prevalence of lifetime and past-month injection drug use were 8.6% (95% CI 6.9, 10.7) and 3.7% (95% CI 2.6, 5.2), respectively. Recent non-injection drug use was associated with divorced marital status (AOR 2.00, 95% CI 1.07, 3.74), temporary marriage (AOR 4.31 [1.79, 10.40]), had > 30 clients per month (AOR 2.76 [1.29, 5.90]), ever alcohol use (AOR 3.03 [1.92, 6.79]), and history of incarceration (AOR 7.65 [3.89, 15.30]). Similarly, lifetime injection drug use was associated with ever alcohol use (AOR 2.74 [1.20–6.20]), ever incarceration (AOR 5.06 [2.48–10.28]), and ever group sex (AOR 2.44 [1.21–4.92]). Conclusions Non-injection and injection drug use are prevalent among street-based FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with drug use among this vulnerable population in Iran.

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