Yonsei Med J.
2020 May;61(5):349-358. 10.3349/ymj.2020.61.5.349.
A Review of Pre-Exposure Prophylaxis Adherenceamong Female Sex Workers
- Ghayda RA
1,2 - Hong SH2,3
- Yang JW4
- Jeong GH5
- Lee KH6
- Kronbichler A7
- Solmi M8
- Stubbs B9,10,11
- Koyanagi A12,13
- Jacob L12,14
- Oh H15
- Kim JY3
- Shin JI6
- Smith L16
- Affiliations
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- 1Division of Urology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- 2Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- 3Yonsei University College of Medicine, Seoul, Korea
- 4Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- 5College of Medicine, Gyeongsang National University, Jinju, Korea
- 6Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
- 7Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria
- 8Department of Neuroscience, Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
- 9Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London, UK
- 10South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK
- 11Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
- 12Parc Sanitari Sant Joan de Déu/CIBERSAM, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- 13ICREA, Pg. Lluis Companys 23, Barcelona, Spain
- 14Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
- 15School of Social Work, University of Southern California, Los Angeles, CA, USA
- 16The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
- KMID: 2500072
- DOI: http://doi.org/10.3349/ymj.2020.61.5.349
Abstract
- Globally and in Africa specifically, female sex workers (FSWs) are at an extraordinarily high risk of contracting human immunodeficiency virus (HIV). Pre-exposure prophylaxis (PrEP) has emerged as an effective and ethical method with which to prevent HIV infection among FSWs. PrEP efficacy is, however, closely linked to adherence, and adherence to PrEP among FSWs is a complex and interrelated process that has been shown to be of importance to public health policies and HIV control and intervention programs. This comprehensive review categorizes barriers to and facilitators of adherence to HIV PrEP for FSWs, and describes five strategies for promoting PrEP adherence among FSWs. These strategies encompass 1) a long-term educational effort to decrease the stigma associated with sex work and PrEP use, 2) education on how PrEP works, 3) lifestyle modification, 4) research on nextgeneration PrEP products to address the inconvenience of taking daily pills, and 5) integration of PrEP into existing services, such as social services and routine primary care visits, to reduce the economic burden of seeking the medication. Our review is expected to be useful for the design of future PrEP intervention programs. Multidisciplinary intervention should be considered to promote PrEP adherence among FSWs in order to help control the HIV epidemic.
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