A Review of Pre-Exposure Prophylaxis Adherence among Female Sex Workers

• Published in: Yonsei medical journal Vol. 61; no. 5; pp. 349 - 358
• Main Authors: Ghayda, Ramy Abou, Hong, Sung Hwi, Yang, Jae Won, Jeong, Gwang Hun, Lee, Keum Hwa, Kronbichler, Andreas, Solmi, Marco, Stubbs, Brendon, Koyanagi, Ai, Jacob, Louis, Oh, Hans, Kim, Jong Yeob, Shin, Jae Il, Smith, Lee
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01-05-2020; 연세대학교의과대학
• Subjects: Human health and pathology; Infectious diseases; Life Sciences; Review; Santé publique et épidémiologie; 의학일반; pre-exposure prophylaxis; drug adherence; female sex workers; Human immunodeficiency virus infection and acquired immune deficiency syndrome prevention; Female sex workers; Drug adherence; Pre-exposure prophylaxis
• ISSN: 0513-5796; 1976-2437
• DOI: 10.3349/ymj.2020.61.5.349

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 next-generation 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.