Table 1. Observational Studies of PrEP Adherence among FSW.
| Author, year | Geographical location | Intervention | Population | Sample size | Follow-up period | Design | Conclusion and key words | Categories |
|---|---|---|---|---|---|---|---|---|
| Mutua, et al., 201244 | Kenya | PrEP | MSW/FSW | 72 | 4 months | Clinical trial | Although adherence is lower than with daily regimens, intermittent PrEP dosing with a fixed regimen in this at-risk population is feasible | Inconvenience |
| Van der Elst, et al., 201335 | Kenya | PrEP | MSW/FSW | 51 | 4 months | Clinical trial | Most participants favored the intermittent dosing schedule; those in the intermittent group noted particular challenges in adhering to the post-coital dose. Culturally appropriate and consistent counseling addressing these issues may be critical for PrEP effectiveness | Lack of knowledge Inconvenience |
| Syvertsen, et al., 20144 | - | PrEP | FSW | - | - | Comprehensive | Involving social scientists in clinical and community-based research on PrEP is very important. Advocating for a shift away from a singular “re-medicalization” of the HIV epidemic to that of a “reintegration” of interdisciplinary approaches to prevention that could benefit FSW and other key populations at risk of acquiring HIV | Social values and stigma |
| Lack of knowledge | ||||||||
| Reynolds, et al., 201543 | USA | PrEP | MSM; heterosexual women and men; injection drug users | 1 | - | Grand rounds discussion | The patient’s risk for HIV transmission from their husband and from other partners, the magnitude of the risk reduction they would gain with PrEP, and nonpharmacologic alternatives to reduce the likelihood of contracting HIV infection | Lifestyle modification |
| Reza-Paul, et al., 201633 | India/Southern Kamataka | PrEP | FSW | 427 | Interview | Situating PrEP scale up within the trusted spaces of community-based organizations should be considered as a means of supporting PrEP roll-out | Social values and stigma | |
| Restar, et al., 201734 | Kenya/Monbasa | PrEP/PEP | MSW/FSW | 21/23 | - | Interview | Despite its availability, few knew about PEP and even fewer had used it, although most who had would use it again. Sex workers valued confidentiality, privacy, trustworthiness, and convenient location in health services and wanted thorough HIV/STI assessments | Lifestyle modification |
| Eakle, et al., 201740 | South Africa/Johannesburg, Pretoria | PrEP/early ART | FSW | 219/139 | 12 months | Part of a cohort study | PrEP and early ART can be aligned with existing health service programming (TAPS) for FSWs safely, without significant behavior change, with high rates of uptake for both interventions, and with expected cost reductions in routine settings at scale Economic burden | Lifestyle modification |
| Pines, et al., 201842 | Mexico-USA border region | PrEP (oral pill/vaginal gel) | FSW | 271 | 6 months | Survey | FSWs indicated a strong preference for oral pills; however, vaginal PrEP products may also facilitate uptake and ensure sufficient coverage | Lack of knowledge |
| Lifestyle modification | ||||||||
| Eakle, et al., 201839 | South Africa | PrEP (focus group discussion) | FSW | 69 | 1–2 hours | Interview | Through FGDs, PrEP became a positive and highly anticipated prevention option among the FSWs participants | Lack of knowledge |
| Eakle, et al., 201841 | South Africa | PrEP/early ART (formative research process) | FSW | - | - | Comprehensive | Formative research is critical in designing interventions, especially in new environments, but also in well-known contexts. Including intensive stakeholder engagement in formative research will help to ensure that interventions are designed with feasibility and relevance for populations in mind | Lack of knowledge |
| Pines, et al., 201959 | Mexico-USA border region | Tijuana vs. Ciudad (Vaginal/washing/Lubrication) | FSW | 145/150 | - | Survey | Vaginal PrEP product development and implementation should also consider the link between vaginal washing and lubrication (area difference) to ensure existing practices do not undermine vaginal PrEP product effectiveness | Lifestyle modification Inconvenience |
ART, antiviral therapy; PrEP, pre-exposure prophylaxis; PEP, post-exposure prophylaxis; MSW, male sex worker; MSM; men who have sex with men; FSW, female sex worker; HIV, human immunodeficiency virus; FGD, Focus Group Discussion; STI, Sexually Transmitted Infection; TAPS study, prospective observational cohort study with two groups (PrEP and early ART for FSWs).