Condom failure and pre-exposure prophylaxis use experience among female sex workers in Ethiopia: a qualitative study.


Journal

BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562

Informations de publication

Date de publication:
31 05 2022
Historique:
received: 15 10 2021
accepted: 19 05 2022
entrez: 1 6 2022
pubmed: 2 6 2022
medline: 3 6 2022
Statut: epublish

Résumé

Female sex workers (FSW) remain a highly exposed group for HIV/STIs due to different factors including condom failure. In Ethiopia, pre-exposure prophylaxis (PrEP) has recently been introduced as an intervention strategy to prevent new HIV infections, but knowledge about FSWs' experiences of condom failure and PrEP use remains scarce. Therefore, this study explores FSWs' experiences concerning condom failure and their attitudes towards, and experiences of, PrEP uptake. A qualitative study using in-depth interviews was conducted among FSWs in Addis Ababa. A manifest and latent content analysis method was applied to identify categories and emerging themes. Seventeen FSWs (10 who started on PrEP, 1 who discontinued, and 6 who didn't start) were interviewed. FSWs described the reasons behind condom failure, the mechanisms they used to minimize the harm, and their attitudes towards PrEP use. FSWs struggled with the continuous risk of condom failure due to factors related to clients' and their own behavior. PrEP was mentioned as one the strategies FSWs used to minimize the harm resulting from condom failure, but PrEP use was compounded with doubts that deterred FSWs from uptake. FSWs' misconceptions, their lack of confidence, and PrEP side effects were also mentioned as the main challenges to start taking PrEP and/or to maintain good adherence. The demands and behavior of the clients and FSWs' own actions and poor awareness were factors that increased the exposure of FSWs to condom failure. In addition, the challenges associated with PrEP uptake suggest the need for user-friendly strategies to counteract these barriers and facilitate PrEP uptake.

Sections du résumé

BACKGROUND
Female sex workers (FSW) remain a highly exposed group for HIV/STIs due to different factors including condom failure. In Ethiopia, pre-exposure prophylaxis (PrEP) has recently been introduced as an intervention strategy to prevent new HIV infections, but knowledge about FSWs' experiences of condom failure and PrEP use remains scarce. Therefore, this study explores FSWs' experiences concerning condom failure and their attitudes towards, and experiences of, PrEP uptake.
METHOD
A qualitative study using in-depth interviews was conducted among FSWs in Addis Ababa. A manifest and latent content analysis method was applied to identify categories and emerging themes.
RESULT
Seventeen FSWs (10 who started on PrEP, 1 who discontinued, and 6 who didn't start) were interviewed. FSWs described the reasons behind condom failure, the mechanisms they used to minimize the harm, and their attitudes towards PrEP use. FSWs struggled with the continuous risk of condom failure due to factors related to clients' and their own behavior. PrEP was mentioned as one the strategies FSWs used to minimize the harm resulting from condom failure, but PrEP use was compounded with doubts that deterred FSWs from uptake. FSWs' misconceptions, their lack of confidence, and PrEP side effects were also mentioned as the main challenges to start taking PrEP and/or to maintain good adherence.
CONCLUSION
The demands and behavior of the clients and FSWs' own actions and poor awareness were factors that increased the exposure of FSWs to condom failure. In addition, the challenges associated with PrEP uptake suggest the need for user-friendly strategies to counteract these barriers and facilitate PrEP uptake.

Identifiants

pubmed: 35641959
doi: 10.1186/s12889-022-13468-3
pii: 10.1186/s12889-022-13468-3
pmc: PMC9158269
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1079

Informations de copyright

© 2022. The Author(s).

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Auteurs

Minilik Demissie Amogne (MD)

Department of Clinical Sciences, Social Medicine and Global Health, Lund University, Malmö, Sweden. minilik_demissie.amogne@med.lu.se.
Ethiopian Public Health Institute, Addis Ababa, Ethiopia. minilik_demissie.amogne@med.lu.se.

Eduard J Sanders (EJ)

KEMRI/Wellcome Trust Research Programme Centre for Geographic Medicine Research-Coast, Kilifi, Kenya.
Nuffield Department of Medicine, University of Oxford, Headington, UK.
Department of Global Health, University of Amsterdam, Amsterdam, The Netherlands.
Kenya Medical Research Institute, Kilifi, Kenya.

Wudinesh Belete Belihu (WB)

Department of Clinical Sciences, Social Medicine and Global Health, Lund University, Malmö, Sweden.
Ethiopian Public Health Institute, Addis Ababa, Ethiopia.

Jesper Sundewall (J)

Department of Clinical Sciences, Social Medicine and Global Health, Lund University, Malmö, Sweden.
HEARD, University of KwaZulu-Natal, Durban, South Africa.

Anette Agardh (A)

Department of Clinical Sciences, Social Medicine and Global Health, Lund University, Malmö, Sweden.

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