Sexual health needs of female sex workers reached by two NGOs in Côte d’Ivoire: considerations for the future implementation of PrEP
item type: conferencePaper
is part of: Journal
publisher: communication orale
  type: Organization
  adr: Address
    locality: London
authors: Person
  surname: Becquet
  given name: Valentine
authors: Person
  surname: Nouaman
  given name: Marcellin
authors: Person
  surname: Plazy
  given name: Mélanie
authors: Person
  surname: Masumbuko
  given name: Jean-Marie
authors: Person
  surname: Anoma
  given name: Camille
authors: Person
  surname: Kouamé
  given name: Soh
authors: Person
  surname: Danel
  given name: Christine
authors: Person
  surname: Eholié
  given name: Serge
authors: Person
  surname: Larmarange
  given name: Joseph
abstract: Aim In West Africa, most countries have mixed HIV epidemics; new tools such as pre-exposure prophylaxis (PrEP) should target in priority most affected populations, particularly female sex workers (FSWs). This paper describes sexual and reproductive health (SRH) needs of FSWs in Côte d’Ivoire to inform the future implementation of PrEP in this population. Method/Issue The ANRS 12361 PrEP-CI cross-sectional and mixed-methods study was designed and implemented with two Ivorian community-based organizations. 1000 FSWs completed a standardized questionnaire assessing women’s sociodemographic characteristics, sexual practices and behaviors, use of community health services, a priori acceptability of PrEP. Twenty-two in-depth interviews and eight focus group discussions were conducted at prostitution sites. FSWs were interviewed about risky practices and sexual behaviors, experiences with violence and discrimination, attitudes regarding HIV and sexually transmitted infections (STIs), and barriers to SRH services. Results/Comments The quantitative and qualitative results showed that FSWs were highly exposed to HIV despite their use of condoms with clients. 91% did not use condoms with their regular partner, despite their acknowledged concurrent sexual partnerships. 23% accepted condomless sexual intercourse for a large sum of money, especially when they had had few previous clients. Moreover, FSWs faced many unmet needs regarding SRH beyond HIV prevention and treatment. Inconsistent condom use exposed FSWs to STIs and undesired pregnancies. However, the prevalence of contraceptive use was low (40%) due to fear of contraception causing sterility. FSWs faced obstacles in accessing SRH care and preferred advice from their peers or self-medication. Discussion Implementing PrEP among FSWs in West Africa, such as in Côte d’Ivoire, constitutes an opportunity to consider the chronic follow-up of HIV-negative FSWs. PrEP initiation should not condition access to SRH services; convers…
presented at: AIDS Impact
date: 2019-07-31
citation key: becquetSexualHealthNeeds2019
rights: All rights reserved