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

Author:

Sarr Moussa12ORCID,Gueye Daouda2,Mboup Aminata2,Diouf Ousmane2,Bao Mame D Bousso2,Ndiaye Anna Julienne2,Ndiaye Birahim P2,Hawes Stephen E3,Tousset Eric4ORCID,Diallo Abdoulaye1,Jones Fatima1,Kane Coumba T25,Thiam Safiatou6,Ndour Cheikh T7,Gottlieb Geoffrey S8,Mboup Souleymane2ORCID

Affiliation:

1. Westat, Inc., Rockville, MD, USA

2. IRESSEF: Institut de Recherche en Santé de Surveillance Epidémiologique et de Formations, Dakar, Sénégal

3. Departments of Epidemiology and Global Health, School of Public Health, University of Washington, Seattle, WA, USA

4. Aardex Group, Vise, Belgium

5. Faculte de Médicine et de Pharmacie, Université Cheikh Anta Diop, Dakar, Sénégal

6. Conseil national de lutte contre le sida (CNLS), Dakar, Sénégal

7. Division de Lutte contre le Sida et les IST, Ministère de la Santé et de l’Action Sociale, Dakar, Sénégal

8. Department of Medicine, Allergy and Infectious Diseases, Center for Emerging and Re-Emerging Infectious Diseases and Department of Global Health, University of Washington, Seattle, WA, USA

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.

Funder

Bill and Melinda Gates Foundation

Publisher

SAGE Publications

Subject

Infectious Diseases,Pharmacology (medical),Public Health, Environmental and Occupational Health,Dermatology

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