Exploring new and existing PrEP modalities among female sex workers and women who inject drugs in a U.S. city

ABSTRACT

To address a shortage in research on Pre-Exposure Prophylaxis (PrEP) amongst women at high risk of HIV acquisition, this study explored the attitudes and preferences of female sex workers (FSW) (n = 15) and women who inject drugs (WWID) (n = 16) to existing (e.g., pill) and new (e.g., injection, implant) PrEP modalities, in Baltimore, Maryland, U.S.A. This study reports on seven focus groups conducted between December 2016 and April 2017 and aims to provide new insights into FSW and WWID attitudes and preferences towards three different PrEP delivery methods (i.e., PrEP pill, PrEP implant, PrEP injection). Results draw upon the PrEP care continuum framework and distill existing factors, including lack of control over side effects with new, longer lasting modalities, better privacy with injections, increased adherence with reduced dosing schedules from longer lasting PrEP and new factors such as perceptibility concerns with respect to the PrEP implant relevant to PrEP uptake and adherence among two important overlapping, at-risk populations. The study contributes to a better understanding of barriers and facilitators to uptake and adherence for FSW and WWID around both existing and new PrEP modalities, with implications for future clinical trials and PrEP interventions with at risk-populations.

KEYWORDS:

• HIV
• female sex worker
• female injection drug user
• PrEP
• Modes of delivery

Acknowledgments

We gratefully acknowledge our study participants and staff from the SAPPHIRE study, in particular Erin Wingo, as well as the Baltimore Needle Exchange Program, BCHD. The Sustained Long-Acting Protection Against HIV (SLAP HIV) study was funded by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health Award number: UM1AI120184; PI Patrick Kiser and Thomas Hope.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The Sustained Long-Acting Protection Against HIV (SLAP HIV) study was funded by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health Award number: UM1AI120184; PI Patrick Kiser and Thomas Hope.