Shea Jaclyn, Bula Agatha, Dunda Wezzie, Hosseinipour Mina C, Golin Carol E, Hoffman Irving F, Miller William C, Go Vivian F, Lungu Thandie, Lancaster Kathryn E
Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina (UNC) at Chapel Hill, Chapel Hill, North Carolina.
UNC Project Malawi, Lilongwe, Malawi.
AIDS Educ Prev. 2019 Oct;31(5):421-432. doi: 10.1521/aeap.2019.31.5.421.
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.
女性性工作者感染艾滋病毒的风险极高。暴露前预防（PrEP）是一种有效的艾滋病毒预防方法，但在女性性工作者所采用的预防策略中纳入PrEP的方法尚付阙如。我们在马拉维利隆圭与44名艾滋病毒阴性的女性性工作者进行了半结构化焦点小组讨论，以探讨她们对PrEP的看法：可接受性、在艾滋病毒预防行为中的整合情况以及使用障碍。PrEP的可接受性很高。使用PrEP的动机源于对自己生命的热爱，以及预计感染艾滋病毒会带来的负面经济影响。PrEP被视为与现有的健康性行为规范相辅相成。许多人认为PrEP可能会与避孕套和定期性传播感染检测一起，为预防艾滋病毒提供额外保护。不可预测的日常生活、耻辱感和副作用是可能影响PrEP使用的障碍。利用现有的艾滋病毒预防策略以及围绕艾滋病毒预防行为的社会规范，可能会对马拉维和撒哈拉以南非洲女性性工作者接受PrEP产生积极影响。
