Factors Associated with Usage of Oral-PrEP among Female Sex Workers in Nairobi, Kenya, Assessed by Self-Report and a Point-of-Care Urine Tenofovir Immunoassay.

Autor: Shah P; Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. Pooja.shah@lshtm.ac.uk., Spinelli M; Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA., Irungu E; Partners for Health and Development in Africa (PHDA), Nairobi, Kenya., Kabuti R; Partners for Health and Development in Africa (PHDA), Nairobi, Kenya., Ngurukiri P; Partners for Health and Development in Africa (PHDA), Nairobi, Kenya., Babu H; Partners for Health and Development in Africa (PHDA), Nairobi, Kenya., Kungu M; Partners for Health and Development in Africa (PHDA), Nairobi, Kenya., Champions TMFS; Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK., Nyabuto C; Partners for Health and Development in Africa (PHDA), Nairobi, Kenya., Mahero A; Partners for Health and Development in Africa (PHDA), Nairobi, Kenya., Devries K; Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK., Kyegombe N; Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.; MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda., Medley GF; Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK., Gafos M; Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK., Seeley J; Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.; Africa Health Research Institute, Durban, Kwa-Zulu Natal, South Africa., Weiss HA; MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology and International Health, London School of Hygiene and Tropical Medicine, London, UK., Kaul R; Departments of Immunology and Medicine, University of Toronto, Toronto, Canada., Gandhi M; Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA., Beattie TS; Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK., Kimani J; Partners for Health and Development in Africa (PHDA), Nairobi, Kenya.
Jazyk: angličtina
Zdroj: AIDS and behavior [AIDS Behav] 2024 Nov; Vol. 28 (11), pp. 3836-3849. Date of Electronic Publication: 2024 Aug 13.
DOI: 10.1007/s10461-024-04455-3
Abstrakt: Pre-exposure prophylaxis (PrEP) is highly effective at reducing HIV acquisition. We aimed to estimate usage of oral-PrEP, and factors associated with adherence among female sex workers (FSWs) in Nairobi, Kenya, using a novel point-of-care urine tenofovir lateral flow assay (LFA). The Maisha Fiti study randomly selected FSWs from Sex Worker Outreach Program clinics in Nairobi. Data were collected from 1003 FSWs from June-October 2019, including surveys on self-reported oral-PrEP adherence. Adherence was also measured using the LFA for HIV-negative FSWs currently taking oral-PrEP. Informed by a social-ecological theoretical framework, we used hierarchical multivariable logistic regression models to estimate associations between individual, interpersonal/community, and structural/institutional-level factors and either self-reported or LFA-assessed adherence. Overall, 746 HIV-negative FSWs aged 18-40 participated in the study, of whom 180 (24.1%) self-reported currently taking oral-PrEP. Of these, 56 (31.1%) were adherent to oral-PrEP as measured by LFA. In the multivariable analyses, associations with currently taking oral-PrEP included having completed secondary education, high alcohol/substance use, feeling empowered to use PrEP, current intimate partner, no recent intimate partner violence, having support from sex worker organisations, experiencing sex work-related stigma, and seeking healthcare services despite stigma. Associations with oral-PrEP LFA-measured adherence measured included having only primary education, experience of childhood emotional violence, belonging to a higher wealth tertile, and being nulliparous. Oral-PrEP adherence, measured by self-report or objectively, is low among FSWs in Nairobi. Programs to improve oral-PrEP usage among FSWs should work to mitigate social and structural barriers and involve collaboration between FSWs, healthcare providers and policymakers.
(© 2024. Crown.)
Databáze: MEDLINE
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