Factors Associated with the Use of Pre-Exposure Prophylaxis as an HIV Prevention Measure among Female Sex Workers in Naivasha Town -Nakuru County

Abstract

The World Health Organization has also suggested the application of pre-exposure prophylaxis (PrEP) as a strategic public health HIV infection prevention intervention among highrisk individuals. Awareness and utilization of PrEP among female sex workers (FSWs) remain low, although PrEP reduces HIV infection by approximately 60–70% in women. The determinants of low use include social Stigma, criminalization of sex workers, and inaccessibility of good health services. The present study investigates the prevalence and determinants of PrEP coverage among FSWs in Naivasha Town, Kenya. It was a convergent design with components of cross-sectional and qualitative study. Quantitative data were computed in SPSS (2018), and qualitative responses in NVivo version 8 using a thematic framework guided by Forrest Keenan et al. (2005). The findings are compared with the Kenya AIDS Strategic Framework (2014/2015–2018/2019), which aims for a 75% reduction in new HIV infections. Most participants were aged 20-40 with a mean of 31.9 years, never married, and had primary or secondary education. The major predictors of PrEP uptake were recent HIV/STI testing, anal sex, drug use, medication adherence, perceived risk of STIs, and Access to non-discriminatory care. Health providers reported several barriers to delivering PrEP services, such as limited demonstration capacity, lack of reporting systems, over-supply, and poor integration into regular care. Although interest in PrEP is high, uptake is low. Uptake-promoting interventions must address the incorporation of PrEP into general HIV prevention programs, minimize Stigma, provide health provider training, simplify supply chain logistics, and enable targeted education among FSWs.