Tarimo Edith A M, Iseselo Masunga K, Ambikile Joel S, Lukumay Gift, Munseri Patricia, Bakari Muhammad, Lyamuya Eligius, Aboud Said, Kawuma Rachel, Seeley Janet
Department of Nursing Management, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
BMC Public Health. 2025 Aug 25;25(1):2906. doi: 10.1186/s12889-025-24202-0.
HIV continues to be a significant global public health problem in low and middle-income countries. Efforts to search for an effective and affordable preventative HIV vaccine are on-going. We investigated the understanding of perceived risk for acquiring HIV and the experience of female sex workers (FSW) in Tanzania, before and after enrolling in an HIV vaccine and Pre-Exposure Prophylaxis Trial.
This was a descriptive qualitative study design nested in a multicentre Phase IIb three-arm, two-stage HIV prophylactic vaccine trial with a second randomization to compare two pre-exposure prophylaxes (PrEPVacc trial) regimens. We present findings from Dar es Salaam site in Tanzania. Fifteen in-depth interviews and four focus group discussions were conducted among FSW who participated in the HIV vaccine and Pre-Exposure Prophylaxis Trial between 2021 and 2023. Data analysis was done manually using the Framework and thematic content analysis approaches.
Two themes emerged from the findings: Apparent risk' of acquiring HIV infection before enrolling in the HIV vaccine trial and Balancing perceived risk' of acquiring HIV infection and preventive measures after enrolling in the HIV Vaccine and Pre-Exposure Prophylaxis Trial. Before enrolling in the trial, the participants perceived themselves at high risk of acquiring HIV infection. They reported inconsistent condom use in multiple relationships with clients whose HIV status was unknown. After enrolling in the trial, the participants reported improved knowledge of HIV prevention, particularly the use of pre-exposure prophylaxis and compliance with preventive measures. However, some participants perceived that the experimental vaccine was an established HIV preventive measure. In addition, condomless sex was still practiced, mainly to get higher payments from the clients.
The knowledge gained on HIV preventive measures by FSW after participation in the trial was valued. However, continued engagement in risky sexual practices and poor compliance with HIV preventive measures highlights the need for continued risk-reduction interventions while searching for an effective HIV vaccine.
在低收入和中等收入国家，艾滋病毒仍然是一个重大的全球公共卫生问题。寻找有效且负担得起的预防性艾滋病毒疫苗的工作正在进行中。我们调查了坦桑尼亚女性性工作者在参加艾滋病毒疫苗和暴露前预防试验前后对感染艾滋病毒感知风险的理解以及她们的经历。
这是一项描述性定性研究设计，嵌套在一项多中心IIb期三臂、两阶段艾滋病毒预防性疫苗试验中，该试验进行了第二次随机分组以比较两种暴露前预防（PrEPVacc试验）方案。我们展示了坦桑尼亚达累斯萨拉姆站点的研究结果。2021年至2023年期间，对参与艾滋病毒疫苗和暴露前预防试验的女性性工作者进行了15次深入访谈和4次焦点小组讨论。使用框架和主题内容分析方法手动进行数据分析。
研究结果出现了两个主题：参加艾滋病毒疫苗试验前感染艾滋病毒的“明显风险”，以及参加艾滋病毒疫苗和暴露前预防试验后感染艾滋病毒的“平衡感知风险”与预防措施。在参加试验之前，参与者认为自己感染艾滋病毒的风险很高。她们报告在与艾滋病毒状况不明的客户的多重关系中使用避孕套的情况不一致。参加试验后，参与者报告对艾滋病毒预防的知识有所提高，特别是暴露前预防的使用和对预防措施的依从性。然而，一些参与者认为实验性疫苗是一种既定的艾滋病毒预防措施。此外，仍有无保护性行为，主要是为了从客户那里获得更高的报酬。
女性性工作者在参与试验后获得的艾滋病毒预防措施知识很有价值。然而，持续参与危险的性行为以及对艾滋病毒预防措施的依从性差，凸显了在寻找有效的艾滋病毒疫苗的同时持续进行降低风险干预措施的必要性。
