Low awareness of pre-exposure prophylaxis among female sex workers in Togo

Title

Low awareness of pre-exposure prophylaxis among female sex workers in Togo

Presenter

Alexandra Bitty-Anderson

Authors

A. Bitty-Anderson * (1), A.W. Bakoubayi (2), F.A. Gbeasor-Komlanvi (3), M. Tchankoni (2), A. Sadio (2), C. Dagnra (4), P. Coffie (5), D. Ekouevi (3)

Institutions

(1) Université de Bordeaux, Public Health, Bordeaux, France, (2) Centre Africain de Recherche en Epidémiologie et en Santé Publique, Lomé, Togo, (3) Université de Lomé, Faculty of Health Sciences, Lomé, Togo, (4) Programme National de Lutte contre le VIH/SIDA, les hépatites virales, et les Infections Sexuellement Transmissibles, Lomé, Togo, (5) Université Félix Houphouet Boigny d''Abidjan, Medical Sciences, Abidjan, Cote D''Ivoire

BACKGROUND: The HIV pandemic remains a public challenge in sub-Saharan African, particularly among Female Sex Workers (FSW). Pre-exposure prophylaxis (PrEP) is an effective HIV prevention method among this high-risk group, however scarcely used in Togo. The aim of this study was to explore PrEP awareness among FSW in Togo.
METHODS: A cross-sectional study was completed in June 2021 among FSW in two cities of Togo: Lomé, the capital city in the South and Kara in the North. A snowball sampling method was used and initial seeds were identified in collaboration with local FSW non-governmental organizations. After consent, a standardized questionnaire was administered by trained research staff.
RESULTS: A total of 447 (300 in Lomé) FSW participated in this study. Median age was 30 (interquartile range [24 ' 38]), and 48.8% (n=218) had a secondary school education or higher. Only 8 (1.8%) were aware of PrEP. After explanation on what PrEP is, 88.5% (n=309) expressed their interest and intention in using PrEP if available. If on PrEP, 12.1% and 47.7% reported they would be willing to engage in condom less sex with clients and partners, respectively. Nearly half (47.4%) were unsure whether PrEP could fully fulfill their HIV prevention needs, and 24.7%, (n=43) of those who believed PrEP could fully fulfill their HIV prevention needs indicated that they would absolutely not use condoms with their clients if on PrEP (p<0.001). A third of FSW (33.8%) indicated that they would find it difficult and very difficult to take PrEP every day without missing a dose, and among them 43.7% (n=66) indicated not feeling capable to take PrEP every day without missing a dose. About one in two (n=223; 49.9%) FSW indicated they would prefer obtaining PrEP at the pharmacy, and only 10.3% (n=46) would prefer access through FSW community-based organizations and peer-educators. More than half (52.8% (n=236) indicated that they would be willing to pay for PrEP if given the option.
CONCLUSIONS: .Despite low awareness, FSW were interested in PrEP for HIV prevention. However, for a successful implementation, long-acting PrEP, non-stigmatizing access to PrEP and steady behavioral prevention should imperatively be considered.

Download the e-Poster (PDF)