Determinants of Intention to Use HIV Pre-exposure Prophylaxis and Condom Use Among a Sample of Cisgender Female Sex Workers Working Mostly Outdoors in Madrid, Spain.

There is scant knowledge regarding pre-exposure prophylaxis (PrEP) use among female sex workers (FSWs) in Europe. Spain recognized FSWs as a population at high risk of acquiring HIV and granted them subsidized access to PrEP when the medication first became nationally available in 2019. Nevertheless...

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Published in:Archives of Sexual Behavior Vol. 53; no. 7; pp. 2817 - 2832
Main Authors: Vazquez Guillamet, Laia J., Valencia, Jorge, Ryan, Pablo, Cuevas-Tascón, Guillermo, del-Olmo-Morales, Miguel Angel, Cobo, Ines, Lazarus, Jeffrey V., Chevance, Guillaume
Format: Article
Published: Springer Nature Jul2024
Subjects:
Online Access:View this record in EBSCOhost
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      dt: Jul2024
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      pub: Springer Nature
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        10.1007/s10508-024-02834-4
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        atl: Determinants of Intention to Use HIV Pre-exposure Prophylaxis and Condom Use Among a Sample of Cisgender Female Sex Workers Working Mostly Outdoors in Madrid, Spain.
      aug:
        au:
          Vazquez Guillamet, Laia J.
          Valencia, Jorge
          Ryan, Pablo
          Cuevas-Tascón, Guillermo
          del-Olmo-Morales, Miguel Angel
          Cobo, Ines
          Lazarus, Jeffrey V.
          Chevance, Guillaume
        affil:
          Health Systems Research Group, Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Calle del Rossellón 171, 1 Floor, ES 08036, Barcelona, Spain
          eHealth Group, Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
          https://ror.org/021018s57 Facultat de Medicina i Ciencies de la Salut, Universitat de Barcelona (UB), c. Casanova 143, 08036, Barcelona, Spain
          Fundación de Investigación Biomédica, Hospital Infanta Leonor, Madrid, Spain
          Madrid Positivo Non-Governmental Organization, Madrid, Spain
          Departamento de Medicina Interna, Hospital Infanta Leonor, Madrid, Spain
          Centro de Investigación Biomédica en Red en Enfermedades Infecciosas, Madrid, Spain
          Asociación in Genero (Interculturalidad y Género), Ciudad Real, Spain
          https://ror.org/021018s57 Faculty of Medicine, Hospital Clínic, University of Barcelona, Barcelona, Spain
      su:
        Women's health
        Medical care
        Sex work
        Condoms
        Social stigma
        Pre-exposure prophylaxis
      sug:
        subj:
          Women's health
          Medical care
          Sex work
          Condoms
          Social stigma
          Other rubber product manufacturing
          All Other Rubber Product Manufacturing
          Pre-exposure prophylaxis
      keyword:
        HIV
        Pre-exposure prophylaxis (PrEP)
        Stigma
        Women's health services
        HIV
        Pre-exposure prophylaxis (PrEP)
        Stigma
        Women's health services
      ab: There is scant knowledge regarding pre-exposure prophylaxis (PrEP) use among female sex workers (FSWs) in Europe. Spain recognized FSWs as a population at high risk of acquiring HIV and granted them subsidized access to PrEP when the medication first became nationally available in 2019. Nevertheless, FSWs represented just 0.2% of PrEP users in 2022. A total of 102 HIV-negative FSWs reached through field activities of local NGOs located in Madrid were interviewed between January and March 2022. Participants were selected through convenience sampling over a fixed recruitment period. FSWs completed a 73-item survey with questions about individual, occupational, social, and structural determinants. The objective of this study was to identify (1) the prevalence of intention to use oral PrEP and its determinants, and (2) the prevalence of inconsistent condom use, which is the risk factor that qualifies FSWs for subsidized PrEP in the national health system, and its determinants. Importantly, the study sample overrepresented street-based FSWs (71.6%). A quarter (25.5%) of the study participants used condoms inconsistently. PrEP awareness was low (9.8%), but intention to use PrEP was high (72.5%). Intention to use oral PrEP was significantly associated with feeling protected against HIV by taking PrEP and perceiving insufficient protection by condom use alone. Inconsistent condom use was significantly associated with frequent heroin/cocaine use, having clients who inject drugs, and willingness to take PrEP despite it not protecting 100% against HIV infection. FSWs, in this specific sample, are likely to benefit from targeted PrEP awareness campaigns and implementation projects that prioritize those who use drugs and are more likely to engage in condomless sex.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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