• Shaylen Foley, Danya E Keene, Roman Shrestha, Shan-Estelle Brown, Kamal Gautam, Ryan A Sutherland, Francesca Maviglia, Rumana Saifi, and Jeffrey A Wickersham.
• Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA.
• Patient Prefer Adher. 2024 Jan 1; 18: 797807797-807.

IntroductionPre-exposure prophylaxis (PrEP) is an effective method for prevention of HIV transmission. Female sex workers (FSW) in Malaysia are at substantially increased risk of acquiring HIV compared to the general female population, yet little is known about this population's current HIV prevention practices or acceptance of PrEP. This study aims to inform the culturally relevant implementation of PrEP through the qualitative exploration of (1) the potential need for PrEP in this population and (2) the factors that determine FSW willingness to use oral PrEP.MethodsIn-depth, semi-structured interviews (n = 30) were conducted with FSW in English, Malay, or Tamil. Transcribed and translated interviews were analyzed using a grounded theory approach.ResultsFSW express positive interest in PrEP but prefer it as a supplement to condoms, not a replacement. Perceived challenges to PrEP use include cost, adherence, and side effects.ConclusionThe findings suggest that in combination with condom use, PrEP may be an acceptable method of HIV prevention. Effective PrEP rollout may also include condom promotion using a peer-driven model, cost subsidies, and sex work harm reduction and empowerment components.© 2024 Foley et al.

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