دورية أكاديمية
أعرض في EDS

HIV pre-exposure prophylaxis for female sex workers: ensuring women's family planning needs are not left behind.

التفاصيل البيبلوغرافية
العنوان: HIV pre-exposure prophylaxis for female sex workers: ensuring women's family planning needs are not left behind.
المؤلفون: Bowring AL; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA.; Burnet Institute, Melbourne, Victoria, Australia., Ampt FH; Burnet Institute, Melbourne, Victoria, Australia.; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Schwartz S; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA., Stoové MA; Burnet Institute, Melbourne, Victoria, Australia.; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Luchters S; Burnet Institute, Melbourne, Victoria, Australia.; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.; Department of Population Health, Aga Khan University, Nairobi, Kenya.; International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium., Baral S; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA., Hellard M; Burnet Institute, Melbourne, Victoria, Australia.; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.; Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia.; Doherty Institute and Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
المصدر: Journal of the International AIDS Society [J Int AIDS Soc] 2020 Feb; Vol. 23 (2), pp. e25442.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: John Wiley & Sons, Inc Country of Publication: Switzerland NLM ID: 101478566 Publication Model: Print Cited Medium: Internet ISSN: 1758-2652 (Electronic) Linking ISSN: 17582652 NLM ISO Abbreviation: J Int AIDS Soc Subsets: MEDLINE
أسماء مطبوعة: Publication: 2017- : Hoboken, NJ : John Wiley & Sons, Inc
Original Publication: [London] : BioMed Central
مواضيع طبية MeSH: Family Planning Services* , Pre-Exposure Prophylaxis* , Sex Workers*, HIV Infections/*prevention & control, Condoms ; Contraception Behavior ; Female ; HIV Infections/drug therapy ; Humans ; Pregnancy ; Reproductive Health Services ; Reproductive Rights ; Safe Sex ; Sexual Behavior
مستخلص: Introduction: Female sex workers (FSWs) experience overlapping burdens of HIV, sexually transmitted infections and unintended pregnancy. Pre-exposure prophylaxis (PrEP) is highly efficacious for HIV prevention. It represents a promising strategy to reduce HIV acquisition risks among FSWs specifically given complex social and structural factors that challenge consistent condom use. However, the potential impact on unintended pregnancy has garnered little attention. We discuss the potential concerns and opportunities for PrEP to positively or negatively impact the sexual and reproductive health and rights (SRHR) of FSWs.
Discussion: FSWs have high unmet need for effective contraception and unintended pregnancy is common in low- and middle-income countries. Unintended pregnancy can have enduring health and social effects for FSWs, including consequences of unsafe abortion and financial impacts affecting subsequent risk-taking. It is possible that PrEP could negatively impact condom and other contraceptive use among FSWs due to condom substitution, normalization, external pressures or PrEP provision by single-focus services. There are limited empirical data available to assess the impact of PrEP on pregnancy rates in real-life settings. However, pregnancy rates are relatively high in PrEP trials and modelling suggests a potential two-fold increase in condomless sex among FSWs on PrEP, which, given low use of non-barrier contraceptive methods, would increase rates of unintended pregnancy. Opportunities for integrating family planning with PrEP and HIV services may circumvent these concerns and support improved SRHR. Synergies between PrEP and family planning could promote uptake and maintenance for both interventions. Integrating family planning into FSW-focused community-based HIV services is likely to be the most effective model for improving access to non-barrier contraception among FSWs. However, barriers to integration, such as provider skills and training and funding mechanisms, need to be addressed.
Conclusions: As PrEP is scaled up among FSWs, there is growing impetus to consider integrating family planning services with PrEP delivery in order to better meet the diverse SRHR needs of FSWs and to prevent unintended consequences. Programme monitoring combined with research can close data gaps and mobilize adequate resources to deliver comprehensive SRHR services respectful of all women's rights.
(© 2020 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society.)
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معلومات مُعتمدة: R01 NR016650 United States NR NINR NIH HHS
فهرسة مساهمة: Keywords: HIV infections; Pre-Exposure Prophylaxis (PrEP); contraception; sex workers; unplanned pregnancy
تواريخ الأحداث: Date Created: 20200218 Date Completed: 20201104 Latest Revision: 20240329
رمز التحديث: 20240329
مُعرف محوري في PubMed: PMC7025091
DOI: 10.1002/jia2.25442
PMID: 32064765
قاعدة البيانات: MEDLINE
الوصف
تدمد:1758-2652
DOI:10.1002/jia2.25442