Acceptability and willingness of HIV pre-exposure prophylaxis amongst female sex workers in China

ABSTRACT

HIV pre-exposure prophylaxis (PrEP) is a highly effective prevention method. It is an attractive self-initiated approach to reduce the spread of HIV amongst female sex workers (FSW). PrEP, however, has not yet achieved its potential to reduce HIV infections partially due to a general lack of awareness from women who may benefit. Aims of this cross-sectional study of 1,466 FSW in China were to understand: levels of awareness of and willingness to use PrEP among female sex workers (FSW) in China, and factors contributing to willingness to use PrEP. We found that awareness (10.2%) and willingness (35.5%) to use PrEP were low in our survey areas. Low PrEP willingness is likely reflective of the overall poor knowledge and understanding of HIV risk and prevention. FSW that demonstrated greater HIV knowledge through having been tested or having greater decision-making involvement in condom use were more willing to use PrEP. Study findings may be used to inform future HIV prevention activities, including possible use of PrEP among FSW at higher risk of incident HIV infection in China.

KEYWORDS:

• HIV
• pre-exposure prophylaxis
• female sex workers
• China

Acknowledgements

The authors wish to thank their partners at the National Centre for AIDS/STD Control and Prevention, Guizhou, Guangdong and Shandong provincial Centers for Disease Control and Prevention and outreach staff for their contributions in identifying participants and study implementation. We would like to thank Dr. R.J. Simonds for his review of the manuscript. We would also like to offer special thanks to the female sex worker participants of this study for their time and willingness to share information. This survey has been supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC) under the terms of 5 U2G PS001188 as well as by the Guizhou, Guangdong and Shandong provincial CDCs and the National Center for AIDS Prevention of China CDC. The authors declare that they have no competing interests. The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention (CDC).

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Adrienne N. Poon http://orcid.org/0000-0001-7918-7813

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by President’s Emergency Plan for AIDS Relief (PEPFAR): [Grant Number 5 U2G PS001188]; Guangzhou CDC; Shandong CDC; Guizhou CDC; National Center for AIDS Prevention of China CDC.