Sexual Violence and Low Rates of HIV Post-exposure Prophylaxis Access Among Female Sex Workers in Brazil

• Published in: AIDS and behavior Vol. 26; no. 12; pp. 4082 - 4092
• Main Authors: de Lima, Acácia Mayra Pereira, Magno, Laio, Luppi, Carla Gianna, Szwarcwald, Célia Landmann, Grangeiro, Alexandre, Santana, Elis Passos, Dourado, Inês
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-12-2022; Springer Nature B.V
• Subjects: Access; Aggression; Disease prevention; Females; Health care; Health Psychology; Health services; HIV; Human immunodeficiency virus; Infectious Diseases; Medicine; Medicine & Public Health; Occupational exposure; Original Paper; Prophylaxis; Prostitution; Public Health; Sex crimes; Sex industry; Sex workers; Sexual assault; Sexually transmitted diseases; STD; Violence; Womens health; Brazil; Female sex workers; Profilaxis posterior a la exposición; Sexual violence; HIV; VIH; Muestreo dirigido por encuestados (MDE); Brazil; Violencia sexual; Post-exposure prophylaxis; Mujeres trabajadoras sexuales; Respondent-driven sampling
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-022-03734-1

Female sex workers (FSW) are disproportionately affected by sexual violence (SV) and HIV. Social and structural barriers limit their access to post-exposure prophylaxis (PEP). Respondent-driven sampling survey in 12 Brazilian cities among 4188 FSW aimed to estimate the rates of SV and factors associated with access to PEP use among FSW who experienced SV. The prevalence of SV was 26.3% (1199). Of the 1199, 7.5% sought out healthcare and used PEP, 19% sought out healthcare, but did not use PEP, and 73.5% did not seek out healthcare after SV. Factors associated with PEP use included PEP awareness, participation in HIV/STI prevention workshops, and disclosure of FSW status in healthcare services. Although Brazil has a PEP program free of charge, it is not readily accessible, even for FSW who seek out healthcare. The development of effective strategies to link FSW to HIV preventive services is urgently needed.