Understanding issues around use of oral pre exposure prophylaxis among female sex workers in India.
Adherence
Alcohol use
FSW
Fear of side-effects
India
Oral PrEP
Qualitative research
Reproductive health
Stigma
Violence
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
08 Sep 2021
08 Sep 2021
Historique:
received:
14
04
2021
accepted:
24
08
2021
entrez:
9
9
2021
pubmed:
10
9
2021
medline:
25
9
2021
Statut:
epublish
Résumé
Empowering female sex workers (FSWs) through women controlled HIV prevention option has been in focus globally. FSWs are important target for oral pre exposure prophylaxis (PrEP). A multi-centric qualitative study was conducted to explore the FSWs' willingness to use oral PrEP in India. Seventy three interviews and 02 focus group discussions were conducted at 3 high HIV prevalent states in India during 2013-14. Study explored issues around willingness to use oral PrEP. The study was approved by the respective institutional ethics committee of the study sites. Thematic analysis using grounded theory approach was used to analyze the data in N-VIVO version 8.0. Thematic analysis showed events of forced condom-less sex. FSWs believed that oral PrEP could provide independence, financial gains, and privacy and therefore hoped to use it as an alternative to male condom. However, any impact on physical/ aesthetic attributes and reproductive system were not acceptable and could become a barrier. Provider initiated oral PrEP was not preferred. Providers voiced safety monitoring concerns. Adherence emerged as a challenge because of: (1) alcohol use; (2) taking PrEP tablet each day being boring; (3) Stigma because Oral PrEP is ARV based. Alcohol use and dread of repetitive dose brings forth the need for long acting oral PrEP. Oral PrEP is acceptable among FSWs; it should be rolled out alongside strong messages on STI protection and PrEP as compliment to condoms. PrEP roll out requires educating communities about HIV treatment versus prevention. Long-acting oral PrEP could address both 'boredom' and alcoholism and sustain adherence.
Sections du résumé
BACKGROUND
BACKGROUND
Empowering female sex workers (FSWs) through women controlled HIV prevention option has been in focus globally. FSWs are important target for oral pre exposure prophylaxis (PrEP). A multi-centric qualitative study was conducted to explore the FSWs' willingness to use oral PrEP in India.
METHODS
METHODS
Seventy three interviews and 02 focus group discussions were conducted at 3 high HIV prevalent states in India during 2013-14. Study explored issues around willingness to use oral PrEP. The study was approved by the respective institutional ethics committee of the study sites. Thematic analysis using grounded theory approach was used to analyze the data in N-VIVO version 8.0.
RESULTS
RESULTS
Thematic analysis showed events of forced condom-less sex. FSWs believed that oral PrEP could provide independence, financial gains, and privacy and therefore hoped to use it as an alternative to male condom. However, any impact on physical/ aesthetic attributes and reproductive system were not acceptable and could become a barrier. Provider initiated oral PrEP was not preferred. Providers voiced safety monitoring concerns. Adherence emerged as a challenge because of: (1) alcohol use; (2) taking PrEP tablet each day being boring; (3) Stigma because Oral PrEP is ARV based. Alcohol use and dread of repetitive dose brings forth the need for long acting oral PrEP.
CONCLUSION
CONCLUSIONS
Oral PrEP is acceptable among FSWs; it should be rolled out alongside strong messages on STI protection and PrEP as compliment to condoms. PrEP roll out requires educating communities about HIV treatment versus prevention. Long-acting oral PrEP could address both 'boredom' and alcoholism and sustain adherence.
Identifiants
pubmed: 34496781
doi: 10.1186/s12879-021-06612-8
pii: 10.1186/s12879-021-06612-8
pmc: PMC8424160
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
930Subventions
Organisme : Indian Council of Medical Research
ID : 5/7/703/09-RHN
Informations de copyright
© 2021. The Author(s).
Références
N Engl J Med. 2012 Aug 2;367(5):423-34
pubmed: 22784038
PLoS One. 2008 May 07;3(5):e2077
pubmed: 18461185
N Engl J Med. 2012 Aug 2;367(5):411-22
pubmed: 22784040
PLoS One. 2014 Jan 22;9(1):e86200
pubmed: 24465956
Gates Open Res. 2019 Jul 5;3:1504
pubmed: 31942537
AIDS Care. 2013;25(4):503-6
pubmed: 23062062
J Int AIDS Soc. 2015 Jul 20;18(4 Suppl 3):19949
pubmed: 26198341
BMC Public Health. 2014 Dec 24;14:1323
pubmed: 25540055
AIDS Behav. 2016 Apr;20(4):776-87
pubmed: 26286343
AIDS. 2012 Apr 24;26(7):F13-9
pubmed: 22333749
Nurs Res. 1966 Winter;15(1):56-61
pubmed: 5175452
J Int AIDS Soc. 2014 Sep 08;17(3 Suppl 2):19157
pubmed: 25224616
Qual Health Res. 2011 May;21(5):587-600
pubmed: 21266706
Science. 2010 Sep 3;329(5996):1168-74
pubmed: 20643915
J Int AIDS Soc. 2014 Sep 08;17(3 Suppl 2):19146
pubmed: 25224610
AIDS Behav. 2013 Jul;17(6):2162-72
pubmed: 23080358
Am J Reprod Immunol. 2013 Feb;69 Suppl 1:122-32
pubmed: 23387931
J Int AIDS Soc. 2015 Jul 20;18(4 Suppl 3):19983
pubmed: 26198346
Annu Rev Public Health. 2013;34:301-16
pubmed: 23297666
Curr Opin HIV AIDS. 2016 Jan;11(1):27-34
pubmed: 26633639
J Int AIDS Soc. 2016 May 30;19(1):20875
pubmed: 27247202
Glob Public Health. 2013;8(5):619-33
pubmed: 23398385
J Int AIDS Soc. 2016 Sep 07;19(1):20942
pubmed: 27609782
N Engl J Med. 2012 Aug 2;367(5):459-61
pubmed: 22784041
N Engl J Med. 2012 Aug 2;367(5):399-410
pubmed: 22784037
Int J Drug Policy. 2008 Apr;19(2):106-12
pubmed: 18187314
J Int AIDS Soc. 2016 Jul 18;19(4 Suppl 3):20856
pubmed: 27435708
Annu Rev Med. 2013;64:219-32
pubmed: 23020883
BMC Public Health. 2013 May 15;13:476
pubmed: 23675685
AIDS. 2016 Jul 31;30(12):1973-83
pubmed: 27149090