“PROTECTED MEANS ARMED”: PERSPECTIVES ON PRE-EXPOSURE PROPHYLAXIS (PREP) AMONG WOMEN WHO ENGAGE IN SEX WORK AND USE DRUGS IN KAZAKHSTAN

McCrimmon T. Frye V. Darisheva M. Starbird L. Cordingley O. Terlikbayeva A. Primbetova S. Gilbert L. El-Bassel N. West B.S.
2023 Guilford Publications

AIDS Education and Prevention
2023 #35 Issue 5 347 - 361 pp.

Pre-exposure prophylaxis (PrEP) for HIV prevention has recently become available in Kazakhstan, but women engaged in sex work who use drugs (WESW-UD) could benefit from tailored approaches to support uptake and adherence. To better understand how best to support WESW-UD at each stage of the PrEP continuum (awareness, acceptability, uptake, and adher-ence), we analyzed data from 30 in-depth interviews and four focus groups with 48 WESW-UD from two cities in Kazakhstan. We conducted thematic analysis to characterize perceptions, barriers, and motivators within each step of the PrEP continuum. Participants reported low awareness, but high interest in PrEP. Motivating factors included optimizing health and increased confidence. Participants expressed many preferences and concerns regarding PrEP modality and delivery. Participants also described how orga-nizational mistrust and social support can prevent or facilitate PrEP uptake or adherence. Kazakhstan’s scale-up of PrEP should consider the needs and preferences of WESW-UD to ensure equitable access.

Central Asia , HIV prevention , pre-exposure prophy-laxis , PrEP , sex work , substance use

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Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, United States
Social Intervention Group, Columbia University School of Social Work, New York, NY, United States
Global Health Research Center of Central Asia, Almaty, Kazakhstan
Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, United States

Department of Sociomedical Sciences
Social Intervention Group
Global Health Research Center of Central Asia
Department of Family and Community Health

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