ArticleFrontiers in public health2024
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.
Article in Frontiers in public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Article
- Longitudinal Patterns of Adherence to Oral HIV Pre-Exposure Prophylaxis Among At-Risk Women in Tanga, Tanzania: A Convergent Analysis of Influencing Factors and Optimization Strategies.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
- 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
- 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
- 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
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Authors and funding
8 authors.
Funding
Abstract
Background: Pre-exposure prophylaxis (PrEP) prevention-effective adherence is of critical importance but challenging particularly among key populations where periods of high HIV risk are frequent. We assessed the use of PrEP with reference to periods of unprotected sex among female sex workers in the city of Tanga. Methods: This was part of the pragmatic quasi-experimental trial for HIV PrEP rollout in Tanzania involving a control cohort of 313 female sex workers aged ≥18 years recruited by respondent-driven sampling and followed for 12 months. PrEP use and periods of condomless or unprotected sex were assessed at the 6th and 12th month of follow-up. Prevention-effective adherence was defined as PrEP use of ≥2 pills/week and ≥6 pills/week for anal and vaginal condomless sex. Multivariable modified Poisson regression was conducted to determine factors influencing PrEP use (≥2 pills/week). Results: Overall, 59.2 and 45.9% of participants had unprotected anal and vaginal sex with a client, respectively. The prevention-effective adherence for anal sex ranged from 8.0% (months 6) to 10.0% (months 12) while that of vaginal sex was from 10.1% (month 6) to 3.8% (month 12). Participants who lived with friends were 25.5 times more likely to use ≥2 PrEP doses per week than those who lived alone (aPR = 25.5; 95%CI: 2.55-255.42, Conclusion: Use of PrEP during periods of unprotected sex was rare among female sex workers. Living with friends, self-reporting good health status, and refusing condomless sex with steady partners were associated with increased use of ≥2 PrEP doses per week. However, accepting condomless sex for increased payment was associated with reduced use of ≥2 PrEP doses per week. This calls for an in-depth study to understand the perspectives and circumstances shaping poor adherence during periods of unprotected sex among female sex workers.
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