Awareness, Willingness and Use of HIV Pre-Exposure Prophylaxis Among Female Sex Workers Living in Dar-es-Salaam, Tanzania

Faini, Diana; Munseri, Patricia; Sandström, Eric; Hanson, Claudia; Bakari, Muhammad

doi:10.1007/s10461-022-03769-4

Cited by 10 publications

(5 citation statements)

References 40 publications

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“…This nding is consistent with a study conducted in Uganda among adolescent boys and young men in Eastern Uganda, which identi ed a negative association between being unmarried and willingness to use LAI-PrEP (24). Another cohort study among FSWs in Tanzania also found that being married/cohabiting or separated/divorced/widowed was independently associated with the use of oral PrEP, which may also apply to LAI-PrEP (25). However, we did not observe signi cant differences in willingness to use LAI-PrEP among participants who discontinued oral PrEP and those who were PrEP naive relative to oral PrEP users.…”

Section: Factors Associated With Willingness To Use Lai-prepcontrasting

confidence: 62%

Willingness to Use Long-acting Injectable Pre-exposure Prophylaxis Among Key Populations at a Large Hiv Prevention Clinic in Kampala, Uganda: a Cross-sectional Study

Lukubuya,

Katana,

Baguma

et al. 2024

Preprint

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Background. Long-acting injectable (LAI)-PrEP provides better protection against HIV compared to oral PrEP, which requires taking a daily pill. Our study aimed to assess knowledge about oral and LAI-PrEP and identify factors associated with willingness to use LAI-PrEP among key populations (KP) in Uganda. Methods. We conducted a cross-sectional study at the Most at Risk Populations Initiative (MARPI) clinic between November and December 2021. Participants were recruited through convenience sampling and interviewed using a structured questionnaire by trained interviewers. Participants were categorised into three groups based on their oral PrEP use: those who had not yet initiated PrEP, those who had discontinued oral PrEP, and those currently on oral PrEP. Modified Poisson regression analysis was performed to determine factors associated with the participant's willingness to use LAI-PrEP. Data was analysed using STATA 14 software. Results. Of the 234 participants, 135 (56.7%) were female, 82.5% knew about LAI-PrEP, and 67.5% were willing to use it. The mean age was 28.7 years (standard deviation [SD] 5.8). Willingness to use LAI-PrEP was less likely among divorced, widowed, or separated individuals than those in relationships (adjusted prevalence ratio [aPR] 0.65, 95% CI: 0.43–0.98). Relative to current oral PrEP users, willingness to use LAI-PrEP was similar among those who discontinued oral PrEP (aPR 1.39, 95% CI: 0.92–2.11) and those who had not yet initiated PrEP but were at risk for HIV (aPR 1.26, 95% CI: 0.83–1.89). Conclusions. In this cross-sectional analysis of diverse members of key populations in Uganda, previous or non-use of oral PrEP was not associated with willingness to use LAI-PrEP relative to current users. Future studies should investigate effective methods for promoting the uptake of long-acting PrEP formulations among populations at high risk of HIV acquisition.

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Section: Factors Associated With Willingness To Use Lai-prepcontrasting

confidence: 62%

Willingness to Use Long-acting Injectable Pre-exposure Prophylaxis Among Key Populations at a Large Hiv Prevention Clinic in Kampala, Uganda: a Cross-sectional Study

Lukubuya,

Katana,

Baguma

et al. 2024

Preprint

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“…Hence the lower preference for unavailable methods when compared to oral PrEP that was provided in the study. Findings from a registration cohort of FSWs enrolled in an HIV vaccine trial in Tanzania and the Partners Demonstration Project that integrated PrEP and ART delivery among HIV Sero-discordant couples in Kenya and Uganda showed higher PrEP use among women whose sexual partners were living with HIV ( 57 , 58 ). Oral PrEP is an available user-controlled method and in the context of sex work, would provide cover in cases of failed condom negotiation or acts of sexual violence from clients of unknown HIV status ( 59–61 ).…”

Section: Discussionmentioning

confidence: 99%

Preference for novel biomedical HIV pre-exposure prophylaxis methods among adolescent girls and young women in Kampala, Uganda: a mixed methods study

Mayanja,

Kayesu,

Kamacooko

et al. 2024

Front. Public Health

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BackgroundNovel HIV pre-exposure prophylaxis (PrEP) methods including a potential future HIV vaccine, will increase prevention options for adolescent girls and young women (AGYW) at high risk of HIV infection in Eastern and Southern Africa, yet data on AGYW’s preferences for various PrEP methods is limited. We investigated preferences for five biomedical PrEP methods (oral, injectable, vaginal ring, implant, HIV vaccine) among 14–24-years-old AGYW in Kampala, Uganda.MethodsFrom January to December 2019, we conducted a mixed methods study including 265 high-risk AGYW. After receiving two education sessions on the five PrEP methods, participants were asked about their “most preferred PrEP method.” Multinomial logistic regression (oral PrEP as reference category) was used to determine participant characteristics associated with method preference. Results are presented as adjusted relative risk ratios (aRRR) with 95% confidence intervals (CI). In-depth interviews were conducted with 20 selected participants to examine reasons influencing PrEP preferences and suggestions for method improvements. Transcripts were analyzed thematically.ResultsParticipants preferred methods were: HIV vaccine (34.7%), oral PrEP (25.7%), injectable PrEP (24.9%), PrEP implant (13.6%), and vaginal ring (1.1%). Preference for injectable PrEP increased with every year of age (aRRR 1.22; 95% CI 1.04–1.44) and among participants with chlamydia or gonorrhoea (aRRR 2.53; 95% CI 1.08–5.90), while it was lower among participants having sexual partner(s) living with HIV or of unknown HIV status (aRRR 0.30; 95% CI 0.10–0.91). Preference for PrEP implants also increased with age (aRRR 1.42; 95% CI 1.14–1.77) and was strong among participants having ≥10 sexual partners in the past 3 months (aRRR 3.14; 95% CI 1.16–8.55), while it was lower among those with sexual partner(s) living with HIV or of unknown HIV status (aRRR 0.25; 95% CI 0.07–0.92). PrEP method preference was influenced by product attributes and prior experiences with similar product forms commonly used in health care.ConclusionAGYW have varied preferences for biomedical PrEP method and those with higher sexual behavioral risk prefer long-acting methods. As we anticipate more available PrEP options, oral PrEP use should be supported among AGYW, especially for those with sexual partners living with HIV or of unknown HIV status.

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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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Awareness, Willingness and Use of HIV Pre-Exposure Prophylaxis Among Female Sex Workers Living in Dar-es-Salaam, Tanzania

Cited by 10 publications

References 40 publications

Willingness to Use Long-acting Injectable Pre-exposure Prophylaxis Among Key Populations at a Large Hiv Prevention Clinic in Kampala, Uganda: a Cross-sectional Study

Willingness to Use Long-acting Injectable Pre-exposure Prophylaxis Among Key Populations at a Large Hiv Prevention Clinic in Kampala, Uganda: a Cross-sectional Study

Preference for novel biomedical HIV pre-exposure prophylaxis methods among adolescent girls and young women in Kampala, Uganda: a mixed methods study

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

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