ArticleBMJ global health2023
Early disengagement from HIV pre-exposure prophylaxis services and associated factors among female sex workers in Dar es Salaam, Tanzania: a socioecological approach.
Article in BMJ global health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 12 citations in OpenAlex.
- Alcohol Use and the Care Continuum for HIV Preexposure Prophylaxis: An Updated Scoping Review of Research and Interventions.AIDS and behavior · 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
- "I Stopped to Prove them Wrong:" Reasons for Discontinuing Daily Oral HIV Pre-exposure Prophylaxis Among Women at High Risk of HIV in Tanzania-A Convergent Mixed Methods Study.AIDS and behavior · 2026Article
- Alcohol Use Disorder Diagnoses and HIV Preexposure Prophylaxis Adherence and Continuation: a Retrospective Cohort Study.Journal of general internal medicine · 2026Article
- The prevalence and factors associated with common mental health conditions among female sex workers in Dar es salaam, Tanzania.PLOS mental health · 2026Article
- From housing to home and belonging: structural violence, ontological (in)security and women's mental health.Frontiers in sociology · 2026Article
- Prevalence and factors associated with mental distress among men at higher risk of HIV infection enrolled in an HIV pre-exposure prophylaxis program in Tanga, Tanzania.Frontiers in psychiatry · 2026Article
- Early and Long-Term Retention in Facility-Based HIV Pre-Exposure Prophylaxis Service Delivery Model Among Women at High Risk of HIV Acquisition in Tanga, Tanzania.HIV/AIDS (Auckland, N.Z.) · 2026Article
- Why do female sex workers disengage from targeted reproductive and sexual health services? Experiences from the Sisters with a Voice programme in Zimbabwe.BMC health services research · 2025Article
- Prevalence and Factors Associated with Probable Alcohol Use Disorder Among Men at Higher Risk of HIV Enrolled in the HIV Pre-Exposure Prophylaxis Program in Tanga, Tanzania. A Call for Integrated Care.Substance abuse and rehabilitation · 2025Article
- Hypothetical Preferences and Concerns for Long-Acting Injectable HIV PrEP Use Among Female Barmaids in Ubungo, Dar Es Salaam, Tanzania.HIV/AIDS (Auckland, N.Z.) · 2025Article
- HIV pre-exposure prophylaxis use during periods of unprotected sex among female sex workers in Tanga city, Tanzania: a control arm analysis of the pragmatic quasi-experimental trial.Frontiers in public health · 2024Article
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPre-exposure prophylaxis (PrEP) is an effective HIV prevention tool when taken as prescribed. However, suboptimal use may challenge its real-life impact. To support female sex workers in their efforts to prevent themselves from HIV, it is essential to identify factors that contribute to early disengagement from PrEP care. In this study, we aimed to estimate the risk of early disengagement from PrEP services among female sex workers in Tanzania and associated factors using a socioecological model as a guiding framework.
methodsThe study was conducted as part of a pragmatic mHealth trial for PrEP roll-out in Dar es Salaam in 2021. We estimated the risk of early disengagement, defined as not presenting for the first follow-up visit (within 56 days of enrolment), and its associations with individual, social, behavioural and structural factors (age, self-perceived HIV risk, mental distress, harmful alcohol use, condom use, number of sex work clients, female sex worker stigma and mobility) using multivariable logistic regression models, with marginal standardisation to obtain adjusted relative risks (aRR).
resultsOf the 470 female sex workers enrolled in the study, 340 (74.6%) did not attend the first follow-up visit (disengaged). Mental distress (aRR=1.14; 95% CI 1.01 to 1.27) was associated with increased risk of disengagement. Participants who reported a higher number of clients per month (10-29 partners: aRR=0.87; 95% CI 0.76 to 0.98 and ≥30 partners: aRR=0.80; 95% CI 0.68 to 0.91) and older participants (≥35 years) (RR=0.75; 95% CI 0.56 to 0.95) had a lower risk of disengagement. CONCLUSIONS AND RECOMMENDATIONS: Early disengagement with the PrEP programme was high. Mental distress, younger age and having fewer clients were risk factors for disengagement. We argue that PrEP programmes could benefit from including mental health screening and treatment, as well as directing attention to younger sex workers and those reporting fewer clients.
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