Factors associated with retention in HIV prevention and treatment clinical services among female sex workers enrolled in a sex workers’ outreach program (SWOP) in Nairobi, Kenya.

Abstract Female sex workers (FSWs) are among the key populations (KP) prioritized for comprehensive HIV programming in Kenya. Retention in the program is critical for prevention of HIV acquisition and transmission among FSWs and their sexual partners. We conducted a retrospective cohort analysis of data collected from FSWs enrolled between October 2016 and September 2017 at seven drop-in centers (DICs) in Nairobi, Kenya, to examine retention in HIV prevention and treatment services and identify the associated factors. We found a 3- and 12- month retention of 24% and 17%, respectively. FSWs aged 20-34 years old were less likely to be retained compared to those 50 years or older. FSWs enrolled in a DIC located in their sub-county of residence or reporting ever using HIV pre- or post-exposure prophylaxis were more likely to be retained. Identifying predictors of FSWs disengagement from HIV services can inform the design and implementation of retention-enabling interventions.

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Differentiated Prevention And Care To Reduce The Risk of HIV Acquisition And Transmission Among Female Sex Workers In Zimbabwe: Study Protocol For The ‘AMETHIST’ Cluster Randomised Trial

10.21203/rs.3.rs-475222/v1 ◽

2021 ◽

Author(s):

Frances Cowan ◽

Fortunate Machingura ◽

Sungai T Chabata ◽

Sanni Ali ◽

Joanna Busza ◽

...

Keyword(s):

At Risk ◽

Hiv Prevention ◽

Sex Workers ◽

Female Sex Workers ◽

Sub Saharan Africa ◽

Total N ◽

Female Sex ◽

Prevention And Treatment ◽

Hiv Acquisition ◽

Risk Of Hiv Acquisition

Abstract Background: Female sex workers (FSW) in sub-Saharan Africa are disproportionately affected by HIV and are critical to engage in both HIV prevention and care. Here we describe our approach to evaluation of the AMETHIST intervention for FSW, adapted to the African context and set in Zimbabwe where there is a nationally-scaled programme for sex workers (Sisters). We hypothesise this intervention will raise uptake and adherence to prevention and treatment among FSW resulting in a reduction in their risk of HIV acquisition/transmission.Methods: The AMETHIST intervention (Adapted Microplanning to Eliminate Transmission of HIV in Sex Transactions) aims to provide risk differentiated prevention and care to FSW through microplanning and self help groups. Twenty two towns with the Sisters programme were randomised using restricted randomisation to either the Sisters programme or the Sister programme plus AMETHIST. The primary outcome is composite and is defined as the proportion of HIV positive FSW at risk of HIV transmission combined with the proportion of HIV negative FSW at risk of HIV acquisition. The outcome will be assessed after two years of intervention delivery in a respondent-driven sampling survey (total n=4400; n=200 FSW recruited at each site). Primary analysis will use the ‘RDS-2’ method to estimate cluster summaries and will adapt Hayes and Moulton’s ‘2-step’ method to adjust effect estimates for individual-level confounders and further adjust for cluster baseline prevalence. An in-depth process evaluation guided by our project trajectory will be undertaken.Discussion: Innovative pragmatic trials are needed to generate evidence on effectiveness of combination interventions in HIV prevention and treatment in different contexts. We describe the design and analysis of such a study.Trial Registration: The trial was registered at Pan African Clinical Trials Registry (PACTR202007818077777) on 2 July 2020.

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“The Drug Will Help Protect My Tomorrow”: Perceptions of Integrating PrEP into HIV Prevention Behaviors Among Female Sex Workers in Lilongwe, Malawi

AIDS Education and Prevention ◽

10.1521/aeap.2019.31.5.421 ◽

2019 ◽

Vol 31 (5) ◽

pp. 421-432

Author(s):

Jaclyn Shea ◽

Agatha Bula ◽

Wezzie Dunda ◽

Mina C. Hosseinipour ◽

Carol E. Golin ◽

...

Keyword(s):

Hiv Prevention ◽

Sexual Behaviors ◽

Sex Workers ◽

Female Sex Workers ◽

Economic Effects ◽

Sub Saharan Africa ◽

Prevention Strategies ◽

Female Sex ◽

Hiv Prevention Strategies ◽

Hiv Acquisition

Female sex workers (FSW) are disproportionately at risk for HIV. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention method, yet approaches for incorporating PrEP within prevention strategies used by FSW are lacking. Semistructured focus group discussions were conducted with 44 HIV-negative FSW in Lilongwe, Malawi to explore perceptions of PrEP: acceptability, integration within HIV prevention behaviors, and barriers to use. Acceptability of PrEP was high. Motivation to use PrEP was rooted in love for one's life, anticipated negative economic effects associated with HIV acquisition. PrEP was viewed as complementary to existing norms for engaging in healthy sexual behaviors. Many felt PrEP may provide extra protection from HIV, along with condoms and frequent STI testing. Unpredictable daily lives, stigma, and side effects were barriers that could affect PrEP use. Leveraging existing HIV prevention strategies and social norms surrounding HIV prevention behaviors may positively impact PrEP uptake among FSW in Malawi and sub-Saharan Africa.

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PIH77 SOCIOECONOMIC INEQUALITY IN HIV PREVENTION AMONGST FEMALE SEX WORKERS: A CROSS-SECTIONAL ANALYSIS OF ORAL PRE-EXPOSURE PROPHYLAXIS IN RURAL KENYA

Value in Health ◽

10.1016/j.jval.2020.04.471 ◽

2020 ◽

Vol 23 ◽

pp. S166

Author(s):

A.E. Achieng' ◽

E. Owiti

Keyword(s):

Hiv Prevention ◽

Sex Workers ◽

Female Sex Workers ◽

Socioeconomic Inequality ◽

Cross Sectional ◽

Female Sex ◽

Cross Sectional Analysis ◽

Rural Kenya ◽

Exposure Prophylaxis ◽

Sectional Analysis

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Acceptability of microbicidal vaginal rings and oral pre-exposure prophylaxis for HIV prevention among female sex workers in a high-prevalence US city

AIDS Care ◽

10.1080/09540121.2017.1300628 ◽

2017 ◽

Vol 29 (11) ◽

pp. 1453-1457 ◽

Cited By ~ 15

Author(s):

Sarah M. Peitzmeier ◽

Catherine Tomko ◽

Erin Wingo ◽

Anne Sawyer ◽

Susan G. Sherman ◽

...

Keyword(s):

Hiv Prevention ◽

Sex Workers ◽

Female Sex Workers ◽

Female Sex ◽

High Prevalence ◽

Vaginal Rings ◽

Exposure Prophylaxis

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Actions taken by female sex workers (FSWs) after condom failure in semi urban Blantyre, Malawi

BMC Women s Health ◽

10.1186/s12905-020-01142-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Donatien Twizelimana ◽

Adamson S. Muula

Keyword(s):

Medical Care ◽

Sexual Intercourse ◽

Sex Workers ◽

Female Sex Workers ◽

Post Exposure Prophylaxis ◽

Cross Sectional ◽

Female Sex ◽

Effective Interventions ◽

Hiv Acquisition ◽

Study Participants

Abstract Background Little is known about actions taken by female sex workers (FSWs) after male condom failure during male–female sexual intercourse. The objective of this study was to investigate the actions taken by FSWs after condom failure among FSWs in semi-urban, Blantyre in Malawi. Methods A cross sectional, qualitative study was conducted among FSWs in Blantyre, Malawi between May and July 2019. Snowballing technique was used to recruit study participants in four purposively selected study sites. Focus group discussions and in-depth interviews were conducted by trained research assistants among 40 FSWs. Data were analyzed using thematic content analysis. Results Study participants reported having taken different actions after condom failure. Out of 18 FSWs who experienced condom failure, 10 reported to have stopped sex immediately and changed the condom and then resumed afterwards. They reported to have douched, urinated, and/or squatted to prevent pregnancy, sexually transmitted infections (STIs) and HIV acquisition. Five study participants reported to have asked for extra pay from the client; 10 FSWs didn’t seek medical care. They thought the actions taken were enough for HIV and pregnancy prevention. Out of the 18 FSWs, only 3 stopped sexual intercourse completely and sought medical care which included post-exposure prophylaxis for HIV, STI treatment, and emergency contraceptives. Another 3 reported that they did not stop the sexual intercourse but only squatted and/or douched after sexual intercourse. The remaining 2 FSWs reported not to have stopped sexual intercourse and no any other actions were taken after the condom failure. Conclusion We report some inadequate behaviors among FSWs after condom failure. Health programs should develop interventions and support the performance of safer sex and actions after condom failure among FSWs to prevent STIs including HIV, and unplanned pregnancies. Interpersonal, structural and policy factors hindering FSWs’ access to perform effective interventions need to be addressed.

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Willingness to use pre-exposure prophylaxis for HIV prevention among female sex workers: a cross-sectional study in China

HIV/AIDS - Research and Palliative Care ◽

10.2147/hiv.s33445 ◽

2012 ◽

pp. 149 ◽

Cited By ~ 4

Author(s):

Bin Peng ◽

Yang ◽

Dai ◽

Liang ◽

Zou ◽

...

Keyword(s):

Hiv Prevention ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Female Sex ◽

Willingness To Use ◽

Exposure Prophylaxis

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Successful integration of HIV pre-exposure prophylaxis into a community-based HIV prevention program for female sex workers in Kolkata, India

International Journal of STD & AIDS ◽

10.1177/0956462420983992 ◽

2021 ◽

Vol 32 (7) ◽

pp. 638-647

Author(s):

Smarajit Jana ◽

Protim Ray ◽

Soma Roy ◽

Abhijit Kadam ◽

Raman R Gangakhedkar ◽

...

Keyword(s):

Hiv Prevention ◽

Sex Workers ◽

Prevention Program ◽

Female Sex Workers ◽

Community Support ◽

Final Visit ◽

Community Based ◽

Female Sex ◽

Exposure Prophylaxis ◽

The Impact

We assessed the impact of pre-exposure prophylaxis (PrEP) in the context of a community-based HIV program among female sex workers (FSWs) in Kolkata, India. This was an open-label, uncontrolled demonstration trial. HIV seronegative FSWs over 18 years were eligible. Participants were administered daily tenofovir/emtricitabine (TDF-FTC) with follow-up visits at months 1, 3, 6, 9, 12, and 15. Drug adherence was monitored by self-report, and a random subset of participants underwent plasma TDF testing. 843 women were screened and 678 enrolled and started on PrEP. Seventy-nine women (11%) did not complete all scheduled visits: four women died of reasons unrelated to PrEP and 75 withdrew, for a 15-month retention rate of 89%. Self-reported daily adherence was over 70%. Among those tested for TDF, the percentage of women whose level reached ≥40 ng/mL was 65% by their final visit. There were no HIV seroconversions, and no evidence of significant changes in sexual behavior. This study demonstrated the feasibility and effectiveness of PrEP for FSWs in Kolkata, with very high levels of adherence to PrEP and no HIV seroconversions. The integration of PrEP into an existing community-based HIV prevention program ensured community support and facilitated adherence.

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