Muhindo Richard, King Rachel, Irie Whitney, Mujugira Andrew, Nakku-Joloba Edith, Okoboi Stephen, Muwanguzi Patience, Odongpiny Eva Laker, Tumwesigye Nazarius Mbona, Castelnuovo Barbara
Department of Nursing, Makerere University College of Health Sciences, Kampala, Uganda.
Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda.
PLoS One. 2025 Mar 20;20(3):e0320065. doi: 10.1371/journal.pone.0320065. eCollection 2025.
Sex workers of all genders have a high risk of HIV acquisition and are a priority population for HIV pre-exposure prophylaxis (PrEP). We aimed to assess current oral PrEP use and associated factors among cisgender female sex workers (FSW) in two Ugandan cities.
We administered a survey questionnaire to 236 HIV-negative FSW in the cities of Mbale and Mbarara from January to March 2020. The survey was nested in a quasi-experimental study to assess the effect of peer education and text message reminders on the uptake of regular sexually transmitted infection (STI) and HIV testing. Using interviewer-administered questionnaires, we obtained data on current self-reported tenofovir-based oral PrEP use. We used modified Poisson regression with robust standard errors to evaluate the factors associated with current oral PrEP usage.
Nearly 70% of FSWs reported taking an HIV test during the past three months. Among the respondents, 33% (33/100) in Mbale and 67% (91/136) in Mbarara reported having ever heard of PrEP. However, only 9.7% (23/236) self-reported currently taking oral-PrEP. In Mbarara, FSWs were twice as likely to be aware of or use oral PrEP than those in Mbale (adjusted prevalence ratio [aPR] 2.33; 95% confidence interval (CI) 1.19-3.97; p = 0.01). Additionally, current use was positively associated with attainment of secondary (aPR 2.50; 95% CI: 1.14-5.45; p = 0.02) or tertiary education (aPR 3.12; 95% CI: 1.09-8.96; p = 0.03).
PrEP use in this cohort of FSWs was low and was associated with location and level of education. To increase PrEP uptake among FSWs, targeted educational campaigns and implementation studies are needed, particularly for those with lower levels of education.
所有性别的性工作者感染艾滋病毒的风险都很高，是艾滋病毒暴露前预防（PrEP）的重点人群。我们旨在评估乌干达两个城市中顺性别女性性工作者（FSW）目前口服PrEP的使用情况及相关因素。
2020年1月至3月，我们对姆巴莱和姆巴拉拉市的236名艾滋病毒阴性的FSW进行了问卷调查。该调查嵌套在一项准实验研究中，以评估同伴教育和短信提醒对定期性传播感染（STI）和艾滋病毒检测接受情况的影响。通过访谈员管理的问卷，我们获取了关于目前自我报告的基于替诺福韦的口服PrEP使用情况的数据。我们使用带有稳健标准误的修正泊松回归来评估与目前口服PrEP使用相关的因素。
近70%的FSW报告在过去三个月内进行了艾滋病毒检测。在受访者中，姆巴莱的33%（33/100）和姆巴拉拉的67%（91/136）报告听说过PrEP。然而，只有9.7%（23/236）的人自我报告目前正在服用口服PrEP。在姆巴拉拉，FSW了解或使用口服PrEP的可能性是姆巴莱的两倍（调整后的患病率比[aPR]为2.33；95%置信区间[CI]为1.19 - 3.97；p = 0.01）。此外，目前的使用情况与接受中等教育（aPR为2.50；95% CI：1.14 - 5.45；p = 0.02）或高等教育（aPR为3.12；95% CI：1.09 - 8.96；p = 0.03）呈正相关。
该FSW队列中PrEP的使用率较低，且与地点和教育水平有关。为了提高FSW中PrEP的接受率，需要开展有针对性的教育活动和实施研究，特别是针对教育水平较低的人群。
