Abstract:
Background: Globally, new HIV infection is occurring more in key and priority population group including Female sexual workers, with the majority of those infections occurring in sub-Saharan Africa. Pre-exposure prophylaxis for HIV prevention (PrEP) is an efficient and user-controlled option to prevent new HIV infections. PrEP has emerged as an effective and ethical method with which to prevent HIV infection among Female Sexual Workers (FSWs). However, an ongoing challenge is early and frequent discontinuation of PrEP use.
Objective: It is set out determine Time to Drug Discontinuation and predictors for Discontinuation of PrEP in South West Ethiopia in Female Sexual Workers enrolled in HIV Pre Exposure prophylaxis from October 2020 to September 2021.
Methods: The study was conducted on Female sexual workers that are enrolled in key population Friendly Clinics located at Public health facilities in South Western Ethiopia. The sample size is calculated using sample size calculation formula for survival analysis. Then the time-to-PrEP discontinuation is examined using a discrete time-to-event data setup. Kaplan-Meier time to-event method is used to estimate the median duration of retention in months. And The log-rank test and cox regression are used to compare retention between varies predictors and co-factors.
Results: Among the 565 Female sexual workers initiated on PrEP 428(75.8%) had the event, discontinued PrEP. And the median survival time is 6.48 months using Kaplan-Meier survival analysis. There is statically significant difference in discontinuation between age groups, history of facing sexual abuse and history of non-condom sex. But no statically significant difference found with Residence, levels of Education, Marital status, months of dispensing and having STI.
Conclusion & recommendation: Further implementation strategies are needed to facilitate improvements in PrEP retention that are tailored to FSWs with special considerations like younger age, uneducated and leave far from health facilities.