PrEP uptake
| Study ID | Uptake | Definition of uptake | Factors associated with (or reasons for) PrEP uptake |
| Facility-based models | |||
| Hensen et al 19 | 33.6% | Ever used/total | FSWs with a high number (10+) of clients (aOR 1.71; 95% CI: 1.06 to 2.76), duration of sex work (<2 years, aOR 0.51; 95% CI: 0.32 to 0.83), having visited a sex worker programme in 12 months (aOR 2.92; 95% CI: 1.91 to 4.46) and ever been offered PrEP were more likely to initiate PrEP. |
| Cowan et al 20 | 38.4% | Enrolled/eligible | NR |
| Franks (2021) | NR | Enrolled/eligible | Decliners were not interested in daily medication and did not believe they needed PrEP*. |
| Leis et al 22 | 60.9% | Current or past user/total | Current PrEP users who experienced emotional violence (aOR 0.23; 95% CI:0.07 to 0.71) had a decline in PrEP use, while those who experienced physical violence (aOR 3.01; 95% CI: 1.16 to 7.81) increased their PrEP use. |
| Pillay et al 23 | 66.3% | Current or past users/those who have heard of PrEP | Reasons for accepting PrEP included being sexually active (34.5%), perceived risk of HIV (25.7%) and had multiple sex partners (23.9%), whereas for decliners failed side effects (41.9%), stigma (12.9%) and daily adherence (12.9%). |
| Jana et al 24 | 80.4% | Enrolled/eligible | Decliners found daily PrEP inconvenient (14%) and feared side effects (43%), while others gave no reason (14%) or did not identify as FSW (29%). |
| Sarr et al 25 | 82.4% | Enrolled/eligible | Unregistered FSWs (RR 1.16; 95% CI: 1.06 to 1.26) more likely to initiate. |
| Kagaayi et al 26 | 82.8% | Enrolled/eligible | NR |
| Mboup et al 27 | 88.3% | Enrolled/eligible | Decliners did not want to take daily pills (4/34), wanted to think more about PrEP (4/34), do not perceive self as at risk (9/34), were afraid of side effects (9/34) and were going out of town (8/34). |
| Eakle et al 28 | 97.8% | NR | NR |
| Community-based models | |||
| Guure et al 29 | 6.4% | Ever used/those who have heard of PrEP | FSWs who were willing to use PrEP had higher odds of ever taking compared with FSWs not willing to take PrEP (OR 43; CI: 2.93 to 150); FSWs who had screened for STIs had higher odds of taking PrEP than those who had never screened (OR 5.2; CI: 1.68 to 11.36). |
| Matambanadzo et al 30 | 33.7% | Enrolled/eligible | NR |
| Witte et al 31 | 55.2% | Enrolled/eligible, not on PrEP already | FSWs with greater social support (aOR 0.81; 95% CI: 0.05 to 0.66) were less likely to initiate, while those with high family stigma related to sex work (aOR 2.2; 95% CI: 1.15 to 4.22) were more likely to initiate PrEP. Decliners expressed inability to adhere to daily medication (16.4%), concerns about side effects (5%) and fear of stigma associated with HIV-positive status (3.8%). |
| Reza-Paul et al 32 | 99.2% | Enrolled/eligible | NR |
*Results not disaggregated for FSWs.
aOR, adjusted OR; FSWs, female sex workers; NR, not reported; PrEP, pre-exposure prophylaxis; RR, relative risk; STIs, sexually transmitted infections.