Communication Dans Un Congrès Année : 2025

Adoption of HIV preexposure prophylaxis (PrEP) among female sex workers (FSWs) in Côte d’Ivoire: complex trajectories and early adopters

Résumé

Introduction The ANRS 12381 PRINCESSE project (November 2019 - June 2023) implemented community-based sexual and reproductive health care, including preexposure prophylaxis (PrEP), for female sex workers (FSWs) in the San Pedro region of Côte d'Ivoire, delivered through mobile clinics at prostitution sites in the San Pedro region. This presentation aims to describe PrEP trajectories and the factors associated with its use, focusing on “early adopters”. Methods A total of 489 women were enrolled in the PRINCESSE cohort. This analysis included 400 FSWs eligible for PrEP (HIV-negative, HBsAg-negative at baseline) enrolled up to December 2022 (i.e. enrolled at least 6 months before cohort closure). Clinical records were analyzed to describe PrEP cascade, follow-up, and PrEP trajectories. A multivariable logistic regression identified factors associated with PrEP early adopters. Results The overall PrEP cascade showed that although 98% of eligible FSWs were interested in PrEP, only 62% initiated PrEP, and 39% renewed it at least once. Follow-up was very short (<6 months) for 48% of FSWs, short (6-12 months) for 15%, seasonal (>12 months with a gap of 6 months between two visits) for 31%, and regular (>12 months with no gap) for 6%. PrEP initiation was high among FSWs with regular (96%), seasonal (83%), or short (80%) follow-up, vs. 39% for those with very short follow-up. Among those who initiated, only 88% (regular), 70% (seasonal), 74% (short), and 35% (very short) renewed PrEP. Among 148 FSWs with regular/seasonal follow-up, four PrEP trajectories were identified (cf. attached figure showing individual trajectories, each line representing a participant's PrEP journey): 15% never initiated PrEP; 39% initiated PrEP before stopping and expressing they were not interested anymore; 18% re-initiated PrEP after an episode of non-interest”; and 28% initiated and never expressed non-interest at a later stage. The last two groups were considered as “early adopters”. Significant factors associated with early PrEP adoption were the usual price of intercourse with clients <1500 FCFA (i.e. 2.3 EUR) (aOR=2.4 [1.2-4.8]) and working in brothels (aOR=3.2 [1.6-6.6]). Conclusions In PRINCESSE, loss-to-follow-up and seasonality of risks limited PrEP adoption. FSWs who were more precarious and less mobile became early adopters of this new prevention tool and could serve as potential ambassadors for promoting its uptake and demand creation.

Fichier non déposé

Dates et versions

hal-05090841 , version 1 (30-05-2025)

Identifiants

  • HAL Id : hal-05090841 , version 1

Citer

Joseph Larmarange, Mélanie Plazy, Marcellin Nouaman, Evelyne Kissi, Rose-Marcelle Dedocoton, et al.. Adoption of HIV preexposure prophylaxis (PrEP) among female sex workers (FSWs) in Côte d’Ivoire: complex trajectories and early adopters. 16th AIDSImpact Conference, AIDSImpact, May 2025, Casablanca, Morocco. ⟨hal-05090841⟩
98 Consultations
0 Téléchargements

Partager

  • More