1 Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
2 Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
AIDS Patient Care STDS. 2019 Feb;33(2):49-57. doi: 10.1089/apc.2018.0182. Epub 2019 Jan 11.
Pre-exposure prophylaxis (PrEP) has the potential to be an empowering HIV prevention tool among female sex workers (FSW), yet little is known about PrEP awareness and interest in this population. Sex workers and Police Promoting Health in Risky Environments (SAPPHIRE) is a prospective cohort study of street-based FSW in Baltimore, MD. A cross-sectional analysis explored awareness and interest in PrEP among HIV-negative FSW. Multivariable Poisson regressions modeled associations between individual, interpersonal, and structural variables and PrEP awareness and interest. Of n = 232 FSW, 66% were white, half were less than 35 years old, 59% injected drugs daily, and 66% sold sex daily. Only 21% of FSW were aware of PrEP, though 74% were interested. PrEP awareness was associated with experiencing client condom coercion [adjusted incidence rate ratio (aIRR) = 0.50, 95% CI: 0.28-0.90] and condomless sex with an intimate partner (aIRR = 0.54, 95% CI: 0.30-0.98). PrEP interest was associated with perceiving PrEP as "very easy" to take (aIRR = 1.91, 95% CI: 1.49-2.45) and moving to an unfamiliar geographic area to sell sex (aIRR = 1.20, 95% CI: 1.04-1.39). Women who had a current gonorrhea or chlamydia infection were less likely to be interested in PrEP (aIRR = 0.75, 95% CI: 0.59-0.95). Though PrEP awareness among FSW is low, there are FSW who are significantly more likely to express interest in PrEP and outreach efforts should target these women. Results suggest that women-controlled HIV prevention methods may be important for reducing incidence among FSW.
暴露前预防（PrEP）有可能成为女性性工作者（FSW）中一种赋权的艾滋病毒预防工具，但人们对这一人群对 PrEP 的认识和兴趣知之甚少。性工作者和警察促进高危环境中的健康（SAPPHIRE）是一项针对巴尔的摩街头 FSW 的前瞻性队列研究。一项横断面分析探讨了 HIV 阴性 FSW 对 PrEP 的认识和兴趣。多变量泊松回归模型分析了个体、人际和结构变量与 PrEP 认识和兴趣之间的关系。在 232 名 FSW 中，66%为白人，一半年龄小于 35 岁，59%每天注射毒品，66%每天卖淫。只有 21%的 FSW 了解 PrEP，尽管 74%表示有兴趣。PrEP 意识与经历客户 condom 强制[调整后的发病率比（aIRR）=0.50，95%可信区间：0.28-0.90]和与亲密伴侣无 condom 性行为[aIRR=0.54，95%可信区间：0.30-0.98]有关。对 PrEP 的兴趣与认为 PrEP“非常容易”服用[aIRR=1.91，95%可信区间：1.49-2.45]和搬到一个不熟悉的地理区域卖淫[aIRR=1.20，95%可信区间：1.04-1.39]有关。目前患有淋病或衣原体感染的女性对 PrEP 不太感兴趣[aIRR=0.75，95%可信区间：0.59-0.95]。尽管 FSW 对 PrEP 的认识水平较低，但仍有相当多的 FSW 更有可能对 PrEP 表示兴趣，而外联工作应针对这些女性。结果表明，女性控制的艾滋病毒预防方法对于降低 FSW 的发病率可能很重要。
