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Mixed-methods protocol for the WiSSPr study: Women in Sex work, Stigma and psychosocial barriers to Pre-exposure prophylaxis in Zambia.
Kumar, Ramya; Rao, Deepa; Sharma, Anjali; Phiri, Jamia; Zimba, Martin; Phiri, Maureen; Zyambo, Ruth; Kalo, Gwen Mulenga; Chilembo, Louise; Kunda, Phidelina Milambo; Mulubwa, Chama; Ngosa, Benard; Mugwanya, Kenneth K; Barrington, Wendy E; Herce, Michael E; Musheke, Maurice.
Afiliación
  • Kumar R; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia ramya.kumar.mlk@gmail.com.
  • Rao D; Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA.
  • Sharma A; University of Washington School of Public Health, Seattle, Washington, USA.
  • Phiri J; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
  • Zimba M; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
  • Phiri M; Zambia Sex Workers Alliance, Lusaka, Zambia.
  • Zyambo R; Zambia Sex Workers Alliance, Lusaka, Zambia.
  • Kalo GM; Tithandizeni Umoyo Network, Lusaka, Zambia.
  • Chilembo L; Tithandizeni Umoyo Network, Lusaka, Zambia.
  • Kunda PM; Tithandizeni Umoyo Network, Lusaka, Zambia.
  • Mulubwa C; Lusaka District Health Office, Zambia Ministry of Health, Lusaka, Zambia.
  • Ngosa B; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
  • Mugwanya KK; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
  • Barrington WE; Epidemiology, Global Health, University of Washington School of Public Health, Seattle, Washington, USA.
  • Herce ME; Epidemiology; Child, Family, and Population Health Nursing; Health Systems and Population Health, University of Washington School of Public Health, Seattle, Washington, USA.
  • Musheke M; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
BMJ Open ; 14(9): e080218, 2024 Sep 05.
Article en En | MEDLINE | ID: mdl-39242170
ABSTRACT

INTRODUCTION:

Women engaging in sex work (WESW) have 21 times the risk of HIV acquisition compared with the general population. However, accessing HIV pre-exposure prophylaxis (PrEP) remains challenging, and PrEP initiation and persistence are low due to stigma and related psychosocial factors. The WiSSPr (Women in Sex work, Stigma and PrEP) study aims to (1) estimate the effect of multiple stigmas on PrEP initiation and persistence and (2) qualitatively explore the enablers and barriers to PrEP use for WESW in Lusaka, Zambia. METHODS AND

ANALYSIS:

WiSSPr is a prospective observational cohort study grounded in community-based participatory research principles with a community advisory board (CAB) of key population (KP) civil society organi sations (KP-CSOs) and the Ministry of Health (MoH). We will administer a one-time psychosocial survey vetted by the CAB and follow 300 WESW in the electronic medical record for three months to measure PrEP initiation (#/% ever taking PrEP) and persistence (immediate discontinuation and a medication possession ratio). We will conduct in-depth interviews with a purposive sample of 18 women, including 12 WESW and 6 peer navigators who support routine HIV screening and PrEP delivery, in two community hubs serving KPs since October 2021. We seek to value KP communities as equal contributors to the knowledge production process by actively engaging KP-CSOs throughout the research process. Expected outcomes include quantitative measures of PrEP initiation and persistence among WESW, and qualitative insights into the enablers and barriers to PrEP use informed by participants' lived experiences. ETHICS AND DISSEMINATION WiSSPr was approved by the Institutional Review Boards of the University of Zambia (#3650-2023) and University of North Carolina (#22-3147). Participants must give written informed consent. Findings will be disseminated to the CAB, who will determine how to relay them to the community and stakeholders.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Estigma Social / Trabajadores Sexuales / Profilaxis Pre-Exposición Límite: Adult / Female / Humans País/Región como asunto: Africa Idioma: En Revista: BMJ Open Año: 2024 Tipo del documento: Article País de afiliación: Zambia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Estigma Social / Trabajadores Sexuales / Profilaxis Pre-Exposición Límite: Adult / Female / Humans País/Región como asunto: Africa Idioma: En Revista: BMJ Open Año: 2024 Tipo del documento: Article País de afiliación: Zambia Pais de publicación: Reino Unido