Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr 5:18:797-807.
doi: 10.2147/PPA.S413423. eCollection 2024.

Exploring Attitudes Toward Pre-Exposure Prophylaxis for HIV Prevention Prior to Implementation Among Female Sex Workers in Malaysia: Results from a Qualitative Study

Shaylen Foley  1 , Danya E Keene  1 , Roman Shrestha  2   3   4 , Shan-Estelle Brown  5 , Kamal Gautam  2 , Ryan A Sutherland  3 , Francesca Maviglia  3 , Rumana Saifi  4 , Jeffrey A Wickersham  3   4
Affiliations

Exploring Attitudes Toward Pre-Exposure Prophylaxis for HIV Prevention Prior to Implementation Among Female Sex Workers in Malaysia: Results from a Qualitative Study

Shaylen Foley et al. Patient Prefer Adherence. .

Abstract

Introduction: Pre-exposure prophylaxis (PrEP) is an effective method for prevention of HIV transmission. Female sex workers (FSW) in Malaysia are at substantially increased risk of acquiring HIV compared to the general female population, yet little is known about this population's current HIV prevention practices or acceptance of PrEP. This study aims to inform the culturally relevant implementation of PrEP through the qualitative exploration of (1) the potential need for PrEP in this population and (2) the factors that determine FSW willingness to use oral PrEP.

Methods: In-depth, semi-structured interviews (n = 30) were conducted with FSW in English, Malay, or Tamil. Transcribed and translated interviews were analyzed using a grounded theory approach.

Results: FSW express positive interest in PrEP but prefer it as a supplement to condoms, not a replacement. Perceived challenges to PrEP use include cost, adherence, and side effects.

Conclusion: The findings suggest that in combination with condom use, PrEP may be an acceptable method of HIV prevention. Effective PrEP rollout may also include condom promotion using a peer-driven model, cost subsidies, and sex work harm reduction and empowerment components.

Keywords: HIV; Malaysia; pre-exposure prophylaxis; sex work.

PubMed Disclaimer

Conflict of interest statement

Ms Shaylen Foley reports grants from The Downs International Health Student Travel Fellowship, during the conduct of the study. The authors report no other conflicts of interest in this work.

Similar articles

See all similar articles

References

    1. Baral S, Beyrer C, Muessig K, et al. Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12(7):538–549. doi:10.1016/s1473-3099(12)70066-x - DOI - PubMed
    1. Bekker L-G, Johnson L, Cowan F, et al. Combination HIV prevention for female sex workers: what is the evidence? Lancet. 2015;385(9962):72–87. doi:10.1016/s0140-6736(14)60974-0 - DOI - PMC - PubMed
    1. Spinner CD, Boesecke C, Zink A, et al. HIV pre-exposure prophylaxis (PrEP): a review of current knowledge of oral systemic HIV PrEP in humans. Infection. 2016;44(2):151–158. doi:10.1007/s15010-015-0850-2 - DOI - PubMed
    1. Shannon K, Crago AL, Baral SD, et al. The global response and unmet actions for HIV and sex workers. Lancet. 2018;392(10148):698–710. doi:10.1016/s0140-6736(18)31439-9 - DOI - PMC - PubMed
    1. Conserve DF, Middelkoop K, King G, Bekker LG. Factors Associated with HIV Discussion and Condom Use with Sexual Partners in an Underserved Community in South Africa. J Health Care Poor Underserved. 2016;27(1):131–144. doi:10.1353/hpu.2016.0015 - DOI - PMC - PubMed