ArticleSexual and reproductive health matters2025
Self-care strategies that support PrEP adherence: a qualitative study with female sex workers in rural Uganda.
Article in Sexual and reproductive health matters, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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6 authors.
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Abstract
The World Health Organization (WHO) recently released revised guidelines on self-care interventions for health and well-being, which, in 2022, included recommendations supporting equitable access to information about and availability of pre-exposure prophylaxis (PrEP) as a self-care strategy. Successful implementation of PrEP as an HIV prevention strategy extends beyond providing access to medication. It hinges on individuals adopting self-care strategies to ensure adherence to PrEP in their daily lives. This paper aims to explore self-care strategies that bolster adherence to oral PrEP among female sex workers in two rural Ugandan settings. Through in-depth interviews with 20 female sex workers residing in fishing communities or Trans-Africa highway towns, we used deductive thematic analysis to explore people-centred and health system-centred perspectives on women's PrEP-related self-care strategies. A people-centred perspective on self-care illustrated a range of self-care strategies to support PrEP adherence conducted by women individually (medication reminders; pairing PrEP with daily habits), and with support from others in familial and social networks (verbal reminders to take tablets; information sharing; shared clinic visits; shared pill-taking routines). A health system-centred perspective illustrated the importance of support from health services and professionals. Examples included information provision; NGO clinics as friendly, safe, non-judgemental spaces; PrEP distribution through home-based care outreach strategies; in-bulk PrEP provision for work-related travel periods; formal integration of female sex workers into the system as peer health workers. By considering both person-centred and health system-centred perspectives on self-care, we can pinpoint strategies for health systems to assist female sex workers and their communities in preventing the acquisition and transmission of HIV.
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