Qualitative focus group discussions exploring PrEP method and service delivery preferences among female sex workers and their managers in four Zambian provinces

BMJ Public Health Pub Date : 2024-02-01 DOI:10.1136/bmjph-2023-000483

E. Evens, Tendai Munthali, Featherstone G. Mangunje, Mercy L Kotaka, Holly M. Burke, Bupe Musonda, Musonda Musonda, Catherine S. Todd

{"title":"Qualitative focus group discussions exploring PrEP method and service delivery preferences among female sex workers and their managers in four Zambian provinces","authors":"E. Evens, Tendai Munthali, Featherstone G. Mangunje, Mercy L Kotaka, Holly M. Burke, Bupe Musonda, Musonda Musonda, Catherine S. Todd","doi":"10.1136/bmjph-2023-000483","DOIUrl":null,"url":null,"abstract":"To describe the experiences of oral HIV pre-exposure prophylaxis (PrEP) use, preferences comparing oral PrEP to future long-acting PrEP products (the dapivirine vaginal ring (PrEP ring) and injectable cabotegravir (CAB PrEP)), and service provision preferences among female sex workers (FSWs) and their managers.Qualitative formative focus group discussions were conducted in two urban (Copperbelt, Lusaka) and two rural (Central, Luapula) provinces in Zambia. Consenting participants included 43 FSWs and 36 sex work managers. Eligible participants self-identified as FSWs or sex work managers, were 18 years or older and spoke English, Nyanja or Bemba.FSWs had a median age of 28 years and 60% reported ever using oral PrEP. Among potential future HIV prevention options, most FSWs preferred longer acting PrEP methods, mainly CAB PrEP over the PrEP ring. This preference was consistent across provinces. Many FSWs had personal oral PrEP experience and appreciated the high effectiveness but conveyed that the realities of daily use, including pill visibility, and attributed side effects did not meet their needs. FSWs and managers also identified frequent stigma and misinformation-related barriers to PrEP access and use at community and facility levels. Most FSWs and managers agreed that informing non-paying or long-term partners of PrEP use was acceptable. Participants offered recommendations for greater sensitisation and peer-led services or service extension through trusted figures in the community.Zambian FSWs and their managers preferred longer acting PrEP methods, particularly CAB PrEP, as part of comprehensive HIV prevention method choice, with little difference between provinces. PrEP programming led by FSW peers, managers or other trusted figures was recommended to address misinformation, sensitise partners and potentially deliver services to circumvent perceived stigma at health facilities.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":"91 ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Public Health","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/bmjph-2023-000483","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

Abstract

To describe the experiences of oral HIV pre-exposure prophylaxis (PrEP) use, preferences comparing oral PrEP to future long-acting PrEP products (the dapivirine vaginal ring (PrEP ring) and injectable cabotegravir (CAB PrEP)), and service provision preferences among female sex workers (FSWs) and their managers.Qualitative formative focus group discussions were conducted in two urban (Copperbelt, Lusaka) and two rural (Central, Luapula) provinces in Zambia. Consenting participants included 43 FSWs and 36 sex work managers. Eligible participants self-identified as FSWs or sex work managers, were 18 years or older and spoke English, Nyanja or Bemba.FSWs had a median age of 28 years and 60% reported ever using oral PrEP. Among potential future HIV prevention options, most FSWs preferred longer acting PrEP methods, mainly CAB PrEP over the PrEP ring. This preference was consistent across provinces. Many FSWs had personal oral PrEP experience and appreciated the high effectiveness but conveyed that the realities of daily use, including pill visibility, and attributed side effects did not meet their needs. FSWs and managers also identified frequent stigma and misinformation-related barriers to PrEP access and use at community and facility levels. Most FSWs and managers agreed that informing non-paying or long-term partners of PrEP use was acceptable. Participants offered recommendations for greater sensitisation and peer-led services or service extension through trusted figures in the community.Zambian FSWs and their managers preferred longer acting PrEP methods, particularly CAB PrEP, as part of comprehensive HIV prevention method choice, with little difference between provinces. PrEP programming led by FSW peers, managers or other trusted figures was recommended to address misinformation, sensitise partners and potentially deliver services to circumvent perceived stigma at health facilities.

查看原文本刊更多论文

焦点小组定性讨论，探讨赞比亚四个省的女性性工作者及其管理者对 PrEP 方法和服务提供的偏好

在赞比亚的两个城市省（铜带省和卢萨卡省）和两个农村省（中央省和卢阿普拉省）开展了定性形成性焦点小组讨论。征得同意的参与者包括 43 名性工作者和 36 名性工作管理者。符合条件的参与者自我认同为女性外阴残割者或性工作管理者，年龄在 18 岁或以上，会讲英语、尼扬贾语或本巴语。女性外阴残割者的年龄中位数为 28 岁，60% 的人表示曾经使用过口服 PrEP。在未来潜在的艾滋病毒预防方案中，大多数女性外阴残割者更倾向于使用长效的 PrEP 方法，主要是 CAB PrEP，而不是 PrEP 环。各省的这一偏好是一致的。许多社会福利工作者有过口服 PrEP 的亲身经历，并对其高效性表示赞赏，但表示日常使用的实际情况（包括药片的可见度）和可归因于药片的副作用并不能满足他们的需求。在社区和医疗机构层面上，社会福利工作者和管理人员还发现了在获取和使用 PrEP 方面经常出现的与污名化和错误信息有关的障碍。大部分的社会福利工作者和管理人员都认为，将 PrEP 的使用情况告知非付费伴侣或长期伴侣是可以接受的。赞比亚的女性外勤工作者及其管理人员更倾向于选择长效的 PrEP 方法，尤其是 CAB PrEP，将其作为综合艾滋病预防方法选择的一部分，各省之间的差异不大。建议由女性外阴残割者的同伴、管理者或其他可信赖的人物领导 PrEP 计划的制定，以解决误导问题，提高合作伙伴的敏感性，并有可能提供服务，以避免在卫生设施中被认为是污名化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

BMJ Public Health

自引率

0.00%

发文量