Exploring acceptability of oral PrEP prior to implementation among female sex workers in South Africa

被引:54
作者
Eakle, Robyn [1 ,2 ,3 ]
Bourne, Adam [4 ]
Mbogua, Judie [1 ]
Mutanha, Nyaradzo [1 ]
Rees, Helen [1 ,5 ]
机构
[1] Univ Witwatersrand, Fac Hlth Sci, Wits Reprod Hlth & HIV Inst, Johannesburg, South Africa
[2] London Sch Hyg & Trop Med, Dept Global Hlth & Dev, Social & Math Epidemiol SaME, London, England
[3] London Sch Hyg & Trop Med, Dept Social & Environm Hlth Res, Sigma Res, London, England
[4] La Trobe Univ, Australian Res Ctr Sex Hlth & Soc, Melbourne, Vic, Australia
[5] London Sch Hyg & Trop Med, Dept Infect Dis Epidemiol, London, England
关键词
HIV prevention; biomedical prevention products; pre-exposure prophylaxis (PrEP); sex work; qualitative research; HIV PREEXPOSURE PROPHYLAXIS; VAGINAL GEL; PREVENTION; INFECTION; MICROBICIDE; TENOFOVIR; SAFETY;
D O I
10.1002/jia2.25081
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Introduction: Female sex workers (FSWs) are at high-risk for HIV acquisition in South Africa, where the advent of new HIV prevention and treatment interventions represent the potential to significantly impact the epidemic. This paper focuses on aspects of PrEP acceptability as a new intervention within the context of a larger service delivery programme including the simultaneous rollout of early ART. This paper explores PrEP acceptability among the FGD participants as future potential users. Methods: FGDs were conducted in two clinic-based sites in Johannesburg and Pretoria. They aimed to explore community-level, multi-dimensional acceptability of PrEP within the context of imminent implementation alongside early ART in the TAPS Demonstration Project. Sex worker peer educators recruited participants from varying sex work locales. Facilitation was in English with adaptation by facilitators into local languages as needed. Transcripts were translated and transcribed into English. Thematic analysis was used to analyse the data. Results: Four FGDs were conducted in each site for a total of eight FDGs and 69 participants. Demographics were largely similar across the sites. Overall, there was strong acceptability of PrEP among participants and positive anticipation for the imminent delivery of PrEP in the local sex worker clinics. Themes arising from the discussions exploring aspects of PrEP acceptability included: awareness and understanding of PrEP; PrEP motivations including choice, control, and vulnerability, managing PrEP risks and worries; and, de-stigmatizing and empowering PrEP delivery. Participant discussions and recommendations highlighted the importance of developing clear education and messaging to accurately convey the concept of PrEP, and intervention integration into supportive and tailored services. Conclusions: Through the course of these FGDs, PrEP became a positive and highly anticipated prevention option among the FSWs participants who endorsed implementation in their communities. Effective integration of PrEP into existing services will include comprehensive health programming where ART is also available, appropriate messaging, and support.
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页数:7
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