乌干达古卢市女性性工作者中暴露前预防用药情况：一项基于社区的横断面研究

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

作者信息

Bongomin Felix, Kibone Winnie, Okot Jerom, Ouma Simple, Madraa Grace, Ojara Francis Williams, Musoke David, Pebolo Pebalo Francis

机构信息

Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda.

School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.

出版信息

Ther Adv Infect Dis. 2023 Sep 8;10:20499361231199550. doi: 10.1177/20499361231199550. eCollection 2023 Jan-Dec.

DOI:10.1177/20499361231199550

PMID:37693859

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10492468/

Abstract

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. < 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, < 0.001], being in a polygamous marriage (aPR: 6.9, 95% CI: 1.32-35.77, = 0.022), practicing sex work in both rural and urban areas (aPR: 2.5, 95% CI: 1.49-4.35, < 0.001), having symptoms of depression (aPR: 3.3, 95% CI: 1.43-7.74, = 0.005), and use of postexposure prophylaxis (PEP) in the past 12 months (aPR: 0.31, 95% CI: 0.17-0.59, < 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.

摘要

背景

暴露前预防（PrEP）是降低非洲女性性工作者等高风险人群中艾滋病毒传播风险的一项重要干预措施，非洲的艾滋病毒流行率仍然很高。我们旨在评估乌干达古卢女性性工作者中PrEP的使用情况。

方法

在这项基于社区的横断面研究中，我们纳入了2023年2月至3月期间从乌干达古卢市的热点地区特意挑选出的艾滋病毒阴性女性性工作者。采用半结构化问卷收集社会人口学特征、生殖数据、性行为以及过去3个月自我报告的PrEP使用情况等数据。使用患者健康问卷-2工具筛查抑郁症状。使用修正的泊松回归分析模型确定PrEP使用的预测因素。P<0.05被认为具有统计学意义。

结果

我们招募了273名女性性工作者，中位年龄为27岁（四分位间距：24 - 32岁）。总体而言，181名（66.3%）参与者使用PrEP。PrEP的使用与以下因素相关：除性工作外有固定收入来源[调整患病率比（aPR）：3.7，95%置信区间（CI）：2.11 - 6.35，P<0.001]、处于多配偶婚姻（aPR：6.9，95%CI：1.32 - 35.77，P = 0.022）、在农村和城市地区都从事性工作（aPR：2.5，95%CI：1.49 - 4.35，P<0.001）、有抑郁症状（aPR：3.3，95%CI：1.43 - 7.74，P = 0.005）以及在过去12个月中使用过暴露后预防（PEP）（aPR：0.31，95%CI：0.17 - 0.59，P<0.001）。