Predictors of willingness to use HIV pre-exposure prophylaxis among female sex workers in Southwest China

Abstract

This research examined predictors of willingness to use pre-exposure prophylaxis (PrEP) among female sex workers (FSW) in Southwest China. The final sample included 395 women (mean age=26.73 years, SD=6.74 years) who were predominantly of Han majority ethnicity (84.6%) and had completed middle-school education or lower (63.0%). Participants were recruited initially from commercial sex venues (e.g., saunas, massage parlors) in the cities of Nanchang, Luizhou, Nanning, Urumqi, and Karamay as well as two districts of Chongqing municipality and subsequently via snowball procedures. They completed a battery of self-report measures assessing beliefs about HIV and PrEP, psychosocial influences, demographics and willingness to use HIV PrEP. Willingness to use HIV PrEP was predicted by high levels of trust in physicians and more reported unmet interpersonal belongingness needs. Beyond these factors, willing and unwilling groups were differentiated on the basis of intervention-specific beliefs (perceived stigma and self-efficacy in use of PrEP). Together, findings suggested interpersonal factors should be considered in concert with perceptions of intervention characteristics in assessing motivations to enroll in PrEP within this particular at-risk group.

Keywords:

• HIV
• pre-exposure prophylaxis
• female sex workers
• China
• health belief model

Acknowledgements

This study was supported by the National Key Project for Infectious Diseases, Ministry of Science and Technology of the People's Republic of China (2008ZX10001 016), the Key Discipline Fund of National 211 Project (NSKD08020), and the New Century Outstanding University Talents Program, State Education Commission China, and Grant (NCET-2008-0870).