ArticlePloS one2022
Persistence on oral pre-exposure prophylaxis (PrEP) among female sex workers in eThekwini, South Africa, 2016-2020.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Evolving landscape of economic evaluations of HIV pre-exposure prophylaxis and pre-exposure prophylaxis implementation strategies: a systematic review.Journal of the International AIDS Society · 2025Pooled it
- Alcohol Use and the Pre-exposure Prophylaxis Continuum of Care Among Men in Rural South Africa: Results from a Longitudinal Study.AIDS and behavior · 2025Trial
- A Population-Based HIV Vaccine Efficacy Trial Design: Statistical Framework and Design Considerations.Vaccines · 2026Review
- Patterns and Predictors of HIV Pre-exposure Prophylaxis (PrEP) Continuity Among Young Women Who Sell Sex in Uganda: A Group-Based Trajectory Modeling Approach.AIDS and behavior · 2026Article
- HIV pre-exposure prophylaxis service delivery among young women at increased risk for HIV acquisition in South Africa: a time-and-motion study.BMC health services research · 2026Article
- "It would have been easier for me to give up if I were alone": how a pilot individualized case management intervention influenced female sex workers' oral HIV pre-exposure prophylaxis use in eThekwini, South Africa.BMC public health · 2026Article
- Beyond Efficacy: The Access, Delivery Systems, Acceptability, Persistence, and Transition Management "ADAPT" Framework for Long-Acting Injectable PrEP in Sub-Saharan Africa.HIV/AIDS (Auckland, N.Z.) · 2026Article
- Establishing a Pharmacy-Based Pre-Exposure Prophylaxis Program for Young Women Who Sell Sex: Protocol for a Randomized Controlled Trial.JMIR research protocols · 2025Article
- High acceptability, feasibility and sustainability of a direct-to-pharmacy differentiated PrEP delivery model in public health HIV clinics in Kenya: perspectives of PrEP clients and healthcare providers.Journal of the International AIDS Society · 2025Article
- Condomless sexual encounters among female sex workers included in a longitudinal coital diary study in Zimbabwe.BMC public health · 2025Article
- Determinants of continuation on HIV pre-exposure propylaxis among female sex workers at a referral hospital in Uganda: a mixed methods study using COM-B model.BMC public health · 2025Article
- A decade of PrEP: the evolution of HIV pre-exposure prophylaxis content and sentiments in South African print news media, 2012-2021.Culture, health & sexuality · 2024Article
- Mixed-methods protocol for the WiSSPr study: Women in Sex work, Stigma and psychosocial barriers to Pre-exposure prophylaxis in Zambia.BMJ open · 2024Article
- Determinants to Continuation on Hiv Pre-exposure Propylaxis Among Female Sex Workers at a Referral Hospital in Uganda: a Mixed Methods Study Using Com-b Model.Research square · 2024Article
- PrEP discontinuation, cycling, and risk: Understanding the dynamic nature of PrEP use among female sex workers in South Africa.PloS one · 2024Article
- Engaging the private sector as part of HIV pre-exposure prophylaxis service delivery in Vietnam: a comparative analysis of uptake, persistence and HIV seroconversion from 2018 to 2023.Frontiers in reproductive health · 2024Article
- Transactional sex and age-disparate sexual partnerships among adolescent girls and young women in Tanzania.Frontiers in reproductive health · 2024Article
- 'Condoms are hard to get by': access to HIV prevention methods during lockdown of the COVID-19 epidemic in eastern Zimbabwe.Global health action · 2023Article
- There is no path to ending AIDS by 2030 without improving human rights.Journal of the International AIDS Society · 2023Article
- Effect of implementation strategies on pre-exposure prophylaxis persistence among female sex workers in South Africa: an interrupted time series study.The lancet. HIV · 2023Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundDespite the established efficacy of PrEP to prevent HIV and the advantages of a user-controlled method, PrEP uptake and persistence by women in both trials and demonstration projects has been suboptimal. We utilized real-world data from an HIV service provider to describe persistence on oral PrEP among female sex workers (FSW) in eThekwini, South Africa.
methodsWe examined time from PrEP initiation to discontinuation among all FSW initiating PrEP at TB HIV Care in eThekwini between 2016-2020. We used a discrete time-to-event data setup and stacked cumulative incidence function plots, displaying the competing risks of 1) not returning for PrEP, 2) client discontinuation, and 3) provider discontinuation. We calculated hazard ratios using complementary log-log regression and sub-hazard ratios using competing risks regression.
resultsThe number of initiations increased each year from 155 (9.3%, n = 155/1659) in 2016 to 1224 (27.5%, n = 1224/4446) in 2020. Persistence 1-month after initiation was 53% (95% CI: 51%-55%). Younger women were more likely to discontinue PrEP by not returning compared with those 25 years and older. Risk of discontinuation through non-return declined for those initiating in later years. Despite the COVID-19 pandemic, a greater number of initiations and sustained persistence were observed in 2020.
conclusionsLow levels of PrEP persistence were observed, consistent with data among underserved women elsewhere. Encouragingly, the proportion of women persisting increased over time, even as the number of women newly initiating PrEP and staff workload increased. Further research is needed to understand which implementation strategies the program may have enacted to facilitate these improvements and what further changes may be necessary.
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Registered trials
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