Sexual health knowledge, interest and acceptability of PrEP in migrant women: the MIMOSA study.

Abstract

Objectives: Migrant women (MW) often experience difficulties in accessing sexual healthcare services. We assess the knowledge and acceptability of (Pre-Exposure Prophylaxis) PrEP in MW.

Methods: We carried out a survey exploring HIV and PrEP knowledge in a cohort of adult MW residing in Padua (Italy). Subsequently, women were counselled about PrEP, screened for sexually transmitted infections (STIs) and asked about PrEP acceptability. We assessed factors correlating with PrEP acceptability using logistic regression.

Results: 221 MW were included, mostly Nigerian (122, 55.2%), asylum seekers (78, 35.3%), with a low level of education (179, 81%), with a median age of 31 (IQR:26-37) years and a median time in Italy of 59 months (IQR:16-82). Of these 86% disclosed a regular sexual activity, 17.4% reported to have experienced non-consensual sexual intercourse, and 9.5% to have been paid for sex. Only 14.5% disclosed to regularly use condoms during sexual intercourse. Since their arrival in Italy, 35.7% had undergone a gynaecological examination, and 50.2% had received a STI screening. 85.5% women did not know how to access contraception, and 28.5% knew about PrEP. After counselling, 16.7% women said they would accept PrEP. PrEP acceptability was associated with living in an asylum seeker centre (AdjOR: 0.08, p = 0.03), international protection status (AdjOR:4.98, p = 0.041) and natural contraception use (AdjOR:5.27, p = 0.024).

Conclusions: Sexual health awareness/care and PrEP uptake in MW were low and highlighted the urgency of tackling the HIV/STI risk in this vulnerable population, by adopting specific outreach programmes and ensuring they receive information, support and empowerment about options to make their sexual health safer.