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HIV status among female sex workers (FSWs) continues to be a significant public health concern. Condom use is associated with HIV cases among FSWs. Gender-based violence (GBV) plays a role in FSWs HIV status. While studies have investigated the relationship between GBV and condom use, little is known about the impact of factors such as perpetrator type and substance use. I aimed to examine whether perpetrator type and substance use affect the relationship between GBV and condom use among FSWs in Tanzania. Secondary data analysis was performed on 1,502 FSWs extracted from the 2020 Tanzanian, John Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO), HIV study. Using SPSS version 25, multivariable logistic regression analyses were performed to assess the impact of perpetrator types and subsequently substance use on the relationship between GBV and condom use. Of the 159 (10.5%) FSWs who reported experiencing GBV, 69 (84.25%) reported using condoms with 14% increased odds (OR = 1.14, 95% CI: 0.61-2.11) compared to those who did not. Including perpetrator types in the model resulted in 12% increased odds with no further change due to alcohol/substance use. Neither of these were statistically significant (p > 0.05). These analyses established no statistically significant relationship between GBV and condom use, with no further influence due to perpetrator types and alcohol/substance use. Findings may lead to social change through sexual health prevention programs by focusing on improving FSWs’ sexual health habits and reducing the number of new HIV cases. Future studies should assess this relationship further using a more representative sample size of FSWs.

Introduction Oral pre‐exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) is highly effective in preventing HIV infection among men who have sex with men (MSM). The effects of consistent personal lubricant use in the rectum on tissue PrEP drug concentrations and the rectal microbiota are unknown. We investigated rectal PrEP drug concentrations and the microbiota in MSM before and after repeated rectal application of a hyperosmolar lubricant. Methods We randomized 60 HIV‐negative MSM to apply 4 mL of hyperosmolar rectal lubricant daily (n = 20), take daily oral TDF/FTC (n = 19), or both (n = 21) for seven days. Blood, rectal biopsies and rectal secretions were collected via rigid sigmoidoscopy before and on day 8 after product use. Tenofovir (TFV) and FTC as well as their intracellular metabolites tenofovir‐diphosphate (TFV‐DP), FTC‐triphosphate (FTC‐TP) were measured by HPLC‐mass spectrometry. Rectal mucosal microbiota was sequenced with 16S rRNA sequencing using Illumina MiSeq. Results Seven days of lubricant application was not associated with differences in PrEP drug concentrations in rectal tissue or secretions. Lubricant use was associated with a decrease in the relative abundance of the Bacteroides genus (p = 0.01) and a non‐significant increase in the Prevotella genus (p = 0.09) in the rectum. PrEP drug concentrations in rectal tissue and secretions were not associated with microbiota composition or diversity either before or after lubricant use. Conclusions Repeated rectal application of a hyperosmolar lubricant does not affect mucosal PrEP drug concentrations but is associated with changes in the rectal microbiome.

IntroductionOral pre‐exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) is highly effective in preventing HIV infection among men who have sex with men (MSM). The effects of consistent personal lubricant use in the rectum on tissue PrEP drug concentrations and the rectal microbiota are unknown. We investigated rectal PrEP drug concentrations and the microbiota in MSM before and after repeated rectal application of a hyperosmolar lubricant.MethodsWe randomized 60 HIV‐negative MSM to apply 4 mL of hyperosmolar rectal lubricant daily (n = 20), take daily oral TDF/FTC (n = 19), or both (n = 21) for seven days. Blood, rectal biopsies and rectal secretions were collected via rigid sigmoidoscopy before and on day 8 after product use. Tenofovir (TFV) and FTC as well as their intracellular metabolites tenofovir‐diphosphate (TFV‐DP), FTC‐triphosphate (FTC‐TP) were measured by HPLC‐mass spectrometry. Rectal mucosal microbiota was sequenced with 16S rRNA sequencing using Illumina MiSeq.ResultsSeven days of lubricant application was not associated with differences in PrEP drug concentrations in rectal tissue or secretions. Lubricant use was associated with a decrease in the relative abundance of the Bacteroides genus (p = 0.01) and a non‐significant increase in the Prevotella genus (p = 0.09) in the rectum. PrEP drug concentrations in rectal tissue and secretions were not associated with microbiota composition or diversity either before or after lubricant use.ConclusionsRepeated rectal application of a hyperosmolar lubricant does not affect mucosal PrEP drug concentrations but is associated with changes in the rectal microbiome.