Evidence map›Paper›PMID 39325776›Full record

ArticlePloS one2024

PrEP discontinuation, cycling, and risk: Understanding the dynamic nature of PrEP use among female sex workers in South Africa.

Lillian M Shipp, Sofia Ryan, Carly A Comins, Mfezi Mcingana, Ntambue Mulumba, Vijayanand Guddera, Deliwe Rene Phetlhu, Harry Hausler, Stefan D Baral, Sheree R Schwartz

Abstract read
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Lillian M ShippDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.ORCID 0000-0001-9332-6488
Sofia RyanHealth Sciences Department, NORC at the University of Chicago, Bethesda, Maryland, United States of America.
Carly A CominsDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.ORCID 0000-0003-2991-4423
Mfezi McinganaTB HIV Care, Cape Town, South Africa.
Ntambue MulumbaTB HIV Care, uMgungundlovu, South Africa.
Vijayanand GudderaTB HIV Care, eThekwini, South Africa.
Deliwe Rene PhetlhuSefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa.ORCID 0000-0002-9502-6486
Harry HauslerTB HIV Care, Cape Town, South Africa.
Stefan D BaralDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.ORCID 0000-0002-5482-2419
Sheree R SchwartzDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.

Funding

Vaccine Response and Immunotherapeutics SWGP30AI094189 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Anna Palmer Durbin · 2012 to 2026
$67.0M
Examining PrEP use, implementation preferences and the potential for social support to improve PrEP delivery and persistence among female sex workers in Durban, South AfricaR01NR016650 · NINR · JOHNS HOPKINS UNIVERSITY · PI BARAL, STEFAN DAVID · 2016 to 2020
$3.2M
Optimizing PrEP implementation and effectiveness among women at high risk for HIV acquisition in South AfricaR01MH121161 · NIMH · JOHNS HOPKINS UNIVERSITY · PI SCHWARTZ, SHEREE RENAE · 2020 to 2024
$3.1M
NIAID NIH HHS P30 AI094189NIMH NIH HHS R01 MH121161NINR NIH HHS R01 NR016650
6 · The paper itself

Abstract

PrEP cycling among women is thought to be safe when there are distinct "seasons of risk." However, cyclical PrEP use over short periods may be associated with increased risk of HIV acquisition. We aimed to characterize key social ecological factors contributing toward PrEP cycling among female sex workers (FSW) in the context of high HIV risk. Semi-structured, in-depth interviews were conducted with 36 FSW at risk for HIV acquisition and 12 key informant (KI) service providers in eThekwini (Durban), South Africa from January-October 2020. FSW identified key factors driving temporary discontinuation of PrEP including relocation, lack of information on or difficulty coping with side effects, and delays in accessing PrEP. In many cases, FSW were motivated to restart PrEP once barriers were overcome. In contrast, KIs emphasized the importance of individual adherence to PrEP and reliance on personal risk assessments when counselling FSW on cycling decisions. FSW and KI perspectives highlight a disconnect between providers' recommendations on the potential for cyclical use of PrEP during periods of minimal risk and actual drivers among FSW causing temporary PrEP discontinuation. Further interventions supporting safe PrEP cycling are needed to ensure decisions around cycling are deliberate and guided by changes in HIV risk rather than external factors.

Indexed as

Anti-HIV AgentsHIV InfectionsPre-Exposure ProphylaxisSex WorkersAdultFemaleHumansSouth AfricaYoung AdultAnti-HIV Agents

Identifiers

PMID39325776
PMCPMC11426525

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.