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

Yonsei Medical Journal 2020년 61권 5호 p.349 ~ 358
 ( Ghayda Ramy Abou ) - Harvard Medical School Brigham and Women’s Hospital Division of Urology

 ( Hong Sung-Hwi ) - Yonsei University College of Medicine
양재원 ( Yang Jae-Won ) - Yonsei University Wonju College of Medicine Department of Internal Medicine
 ( Jeong Gwang-Hun ) - Gyeongsang National University College of Medicine
 ( Lee Keum-Hwa ) - Yonsei University College of Medicine Department of Pediatrics
 ( Kronbichler Andreas ) - Austria Medical University Innsbruck Department of Internal Medicine IV
 ( Solmi Marco ) - University of Padova Department of Neurosciences
 ( Stubbs Brendon ) - King’s College London Institute of Psychiatry, Psychology and Neuroscience
 ( Koyanagi Ai ) - Universitat de Barcelona
 ( Jacob Louis ) - Universitat de Barcelona
 ( Oh Hans ) - University of Southern California School of Social Work
 ( Kim Jong-Yeob ) - Yonsei University College of Medicine
신재일 ( Shin Jae-Il ) - Yonsei University College of Medicine Department of Pediatrics
 ( Smith Lee ) - Anglia Ruskin University Cambridge Centre for Sport and Exercise Sciences

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 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.

키워드

Human immunodeficiency virus infection and acquired immune deficiency syndrome prevention; pre-exposure prophylaxis; drug adherence; female sex workers
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