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Condom failure and pre-exposure prophylaxis use experience among female sex workers in Ethiopia : a qualitative study

Amogne, Minilik Demissie LU orcid ; Sanders, Eduard J LU ; Belihu, Wudinesh Belete LU orcid ; Sundewall, Jesper LU and Agardh, Anette LU orcid (2022) In BMC Public Health 22(1).
Abstract

BACKGROUND: Female sex workers (FSW) remain a highly exposed group for HIV/STIs due to different factors including condom failure. In Ethiopia, pre-exposure prophylaxis (PrEP) has recently been introduced as an intervention strategy to prevent new HIV infections, but knowledge about FSWs' experiences of condom failure and PrEP use remains scarce. Therefore, this study explores FSWs' experiences concerning condom failure and their attitudes towards, and experiences of, PrEP uptake.

METHOD: A qualitative study using in-depth interviews was conducted among FSWs in Addis Ababa. A manifest and latent content analysis method was applied to identify categories and emerging themes.

RESULT: Seventeen FSWs (10 who started on PrEP, 1... (More)

BACKGROUND: Female sex workers (FSW) remain a highly exposed group for HIV/STIs due to different factors including condom failure. In Ethiopia, pre-exposure prophylaxis (PrEP) has recently been introduced as an intervention strategy to prevent new HIV infections, but knowledge about FSWs' experiences of condom failure and PrEP use remains scarce. Therefore, this study explores FSWs' experiences concerning condom failure and their attitudes towards, and experiences of, PrEP uptake.

METHOD: A qualitative study using in-depth interviews was conducted among FSWs in Addis Ababa. A manifest and latent content analysis method was applied to identify categories and emerging themes.

RESULT: Seventeen FSWs (10 who started on PrEP, 1 who discontinued, and 6 who didn't start) were interviewed. FSWs described the reasons behind condom failure, the mechanisms they used to minimize the harm, and their attitudes towards PrEP use. FSWs struggled with the continuous risk of condom failure due to factors related to clients' and their own behavior. PrEP was mentioned as one the strategies FSWs used to minimize the harm resulting from condom failure, but PrEP use was compounded with doubts that deterred FSWs from uptake. FSWs' misconceptions, their lack of confidence, and PrEP side effects were also mentioned as the main challenges to start taking PrEP and/or to maintain good adherence.

CONCLUSION: The demands and behavior of the clients and FSWs' own actions and poor awareness were factors that increased the exposure of FSWs to condom failure. In addition, the challenges associated with PrEP uptake suggest the need for user-friendly strategies to counteract these barriers and facilitate PrEP uptake.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMC Public Health
volume
22
issue
1
article number
1079
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85131000954
  • pmid:35641959
ISSN
1471-2458
DOI
10.1186/s12889-022-13468-3
language
English
LU publication?
yes
additional info
© 2022. The Author(s).
id
9ca0af42-a972-452f-adf2-c47c478d691e
date added to LUP
2022-06-02 15:08:37
date last changed
2024-05-15 21:48:13
@article{9ca0af42-a972-452f-adf2-c47c478d691e,
  abstract     = {{<p>BACKGROUND: Female sex workers (FSW) remain a highly exposed group for HIV/STIs due to different factors including condom failure. In Ethiopia, pre-exposure prophylaxis (PrEP) has recently been introduced as an intervention strategy to prevent new HIV infections, but knowledge about FSWs' experiences of condom failure and PrEP use remains scarce. Therefore, this study explores FSWs' experiences concerning condom failure and their attitudes towards, and experiences of, PrEP uptake.</p><p>METHOD: A qualitative study using in-depth interviews was conducted among FSWs in Addis Ababa. A manifest and latent content analysis method was applied to identify categories and emerging themes.</p><p>RESULT: Seventeen FSWs (10 who started on PrEP, 1 who discontinued, and 6 who didn't start) were interviewed. FSWs described the reasons behind condom failure, the mechanisms they used to minimize the harm, and their attitudes towards PrEP use. FSWs struggled with the continuous risk of condom failure due to factors related to clients' and their own behavior. PrEP was mentioned as one the strategies FSWs used to minimize the harm resulting from condom failure, but PrEP use was compounded with doubts that deterred FSWs from uptake. FSWs' misconceptions, their lack of confidence, and PrEP side effects were also mentioned as the main challenges to start taking PrEP and/or to maintain good adherence.</p><p>CONCLUSION: The demands and behavior of the clients and FSWs' own actions and poor awareness were factors that increased the exposure of FSWs to condom failure. In addition, the challenges associated with PrEP uptake suggest the need for user-friendly strategies to counteract these barriers and facilitate PrEP uptake.</p>}},
  author       = {{Amogne, Minilik Demissie and Sanders, Eduard J and Belihu, Wudinesh Belete and Sundewall, Jesper and Agardh, Anette}},
  issn         = {{1471-2458}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Public Health}},
  title        = {{Condom failure and pre-exposure prophylaxis use experience among female sex workers in Ethiopia : a qualitative study}},
  url          = {{http://dx.doi.org/10.1186/s12889-022-13468-3}},
  doi          = {{10.1186/s12889-022-13468-3}},
  volume       = {{22}},
  year         = {{2022}},
}