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. 2020 Oct;31(11):1063-1072.
doi: 10.1177/0956462420943704. Epub 2020 Aug 20.

Uptake, retention, and outcomes in a demonstration project of pre-exposure prophylaxis among female sex workers in public health centers in Senegal

Moussa Sarr  1   2 , Daouda Gueye  2 , Aminata Mboup  2 , Ousmane Diouf  2 , Mame D Bousso Bao  2 , Anna Julienne Ndiaye  2 , Birahim P Ndiaye  2 , Stephen E Hawes  3 , Eric Tousset  4 , Abdoulaye Diallo  1 , Fatima Jones  1 , Coumba T Kane  2   5 , Safiatou Thiam  6 , Cheikh T Ndour  7 , Geoffrey S Gottlieb  8 , Souleymane Mboup  2
Affiliations

Uptake, retention, and outcomes in a demonstration project of pre-exposure prophylaxis among female sex workers in public health centers in Senegal

Moussa Sarr et al. Int J STD AIDS. 2020 Oct.

Abstract

The Senegal pre-exposure prophylaxis (PrEP) Demonstration Project was an open-label cohort study assessing the delivery of daily oral PrEP to HIV-negative female sex workers (FSWs) in four Ministry of Health (MoH)-run clinics in Dakar, Senegal. We assessed uptake, retention in care, and adherence over up to 12 months of follow-up as well as HIV infection rates. Between July and November 2015, 350 individuals were approached and 324 (92.6%) were preliminarily eligible. Uptake was high, with 82.4% of eligible participants choosing to enroll and take PrEP. The mean age of those enrolled was 37.7 years (SD = 8.7), and approximately half had not attended school (41.2%). Among the 267 participants who were prescribed PrEP, 79.9 and 73.4% were retained in PrEP care at 6 and 12 months, respectively. Older age among FSWs was found to be the only significant predictor of lower discontinuation. We did not find significant differences in retention by site, education, condom use, or HIV risk perception. There were no new HIV infections at follow-up. Our results showed evidence of high interest in PrEP and very good PrEP retention rates among FSWs at 12-month follow-up when offered in MoH-run clinics, with older age as the only significant predictor of higher PrEP retention. This highlights the role that these clinics can play in expanding PrEP access nationwide.

Keywords: Africa; HIV; prevention; sex workers; women.

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Conflict of interest statement

Declaration of conflicting interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Recruitment process of the PrEP demonstration study. FSW: female sex worker; HBsAg+: positive hepatitis B surface antigen; β-HCG: Beta-Human Chorionic Gonadotropin.
Figure 2.
Figure 2.
Kaplan–Meier curve for time to PrEP discontinuation. PrEP: pre-exposure prophylaxis. Note: Red line represents the retention probability at 365 days.
Figure 3.
Figure 3.
Daily proportion of subjects taking PrEP as prescribed and as measured by MEMS®. (Broken curve = observed proportion, smooth curve = model predictions, rectangle = intervention visits).
See this image and copyright information in PMC

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