Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Phia Consulting, New York, New York, USA.
BMJ Open. 2022 Aug 17;12(8):e058611. doi: 10.1136/bmjopen-2021-058611.
Modalities of pre-exposure prophylaxis (PrEP) for HIV prevention offer options to women at high risk including female sex workers (FSW). This study aimed to explore FSW's acceptability and preferences for oral pills, long-acting (LA) injectable and vaginal ring PrEP.
Sequential, explanatory, mixed methods.
Iringa, Tanzania.
FSW aged above 18 were recruited from sex work venues using time-location sampling (n=496); HIV-uninfected (n=293) were included in this analysis. Subsequently, survey participants were recruited for in-depth interviews (n=10) and two focus group discussions (n=20).
(1) Acceptability of PrEP (Do you personally think it would be worth it to you to take ART if it could prevent HIV?: yes/no) and (2) preference for LA injectable versus oral pills (If you personally were going to take ART to prevent HIV infection, would you prefer to take it in the form of a daily pill or an injection once every 3 months? Injection/pill).
Participants were (92%) unaware of PrEP but 58% thought it would be worth it to personally take PrEP. Acceptability of PrEP was significantly associated with higher social cohesion (aOR 2.12; 95% CI 1.29 to 3.50) and STI symptoms in the past 6 months (aOR 2.52; 95% CI 1.38 to 4.62). Most (88%) preferred LA vs oral PrEP. Qualitative findings revealed generally positive reactions to all types of PrEP, and they were viewed as a welcome backup to condoms. Participants had concerns about pills (burden of daily use, stigma from clients), and the vaginal ring (fear of client noticing and becoming suspicious, fear of infertility) and overall preferred LA-PrEP (less frequent use, easy to hide, belief in higher efficacy).
Offering multiple formulations of PrEP within the context of community-driven HIV prevention interventions among FSW may facilitate increased uptake and adherence. LA injectable PrEP may be a particularly preferred formulation among FSW.
NCT02281578.
暴露前预防（PrEP）的模式为包括性工作者（FSW）在内的高危女性提供了选择。本研究旨在探索 FSW 对口服药丸、长效（LA）注射剂和阴道环 PrEP 的可接受性和偏好。
顺序、解释性、混合方法。
坦桑尼亚伊林加。
招募了年龄在 18 岁以上的性工作者，使用时间地点抽样法（n=496）；从中招募了 293 名 HIV 未感染者进行此分析。随后，招募了调查参与者进行深入访谈（n=10）和两次焦点小组讨论（n=20）。
（1）PrEP 的可接受性（如果可以预防 HIV，您个人认为服用抗逆转录病毒药物是否值得？：是/否）和（2）对 LA 注射剂与口服药丸的偏好（如果您个人要服用抗逆转录病毒药物预防 HIV 感染，您更愿意以每日药丸还是每 3 个月注射一次的形式服用？注射/药丸）。
参与者（92%）不了解 PrEP，但 58%的人认为亲自服用 PrEP 是值得的。PrEP 的可接受性与较高的社会凝聚力显著相关（aOR 2.12；95%CI 1.29 至 3.50）和过去 6 个月的性传播感染症状（aOR 2.52；95%CI 1.38 至 4.62）。大多数（88%）更喜欢 LA 与口服 PrEP。定性研究结果显示，对所有类型的 PrEP 均有积极反应，认为这是对避孕套的有益补充。参与者对药丸（日常使用的负担、来自客户的耻辱感）和阴道环（担心客户注意到并产生怀疑、担心不孕）有顾虑，总体上更喜欢 LA-PrEP（使用频率较低、易于隐藏、对更高疗效的信任）。
在社区驱动的 FSW 艾滋病毒预防干预背景下提供多种 PrEP 制剂可能有助于提高使用率和依从性。LA 注射剂 PrEP 可能是 FSW 特别偏好的制剂。
NCT02281578。
