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Barriers to Oral PrEP: A Qualitative Study of Female Sex Workers, PrEP Prescribers, Policymakers, and Community Advocates in Morocco
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Barriers to Oral PrEP: A Qualitative Study of Female Sex Workers, PrEP Prescribers, Policymakers, and Community Advocates in Morocco
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Journal Article
Barriers to Oral PrEP: A Qualitative Study of Female Sex Workers, PrEP Prescribers, Policymakers, and Community Advocates in Morocco
2024
Overview
In 2017, Morocco became the first Arab country to incorporate pre-exposure prophylaxis (PrEP) in its HIV-prevention program. Yet no research has been published on PrEP from Morocco. Although female sex workers are one of the target populations of PrEP in Morocco, their enrollment in PrEP is lower than men who have sex with men. In this study, we conducted 38 semi-structured interviews with female sex workers, physicians who prescribe PrEP, policymakers, and community advocates to identify problems associated with access to and use of PrEP. We also investigated preferences for daily oral, vaginal ring, and long-acting injectable PrEP. A reflexive thematic analysis revealed seven themes: PrEP stigma; stigmatization and criminalization of sex work; one size doesn’t fit all; knowledge and misconceptions about PrEP; economic burden; inconvenience of PrEP pills; and preferred PrEP modalities. This paper discusses the implications of the findings for increasing access and use of PrEP in Morocco.
Plain Language Summary
Factors that Influence Uptake of Oral PrEP among Female Sex Workers
One of the most recent scientific advancements in the history of the HIV pandemic was the introduction of pre-exposure prophylaxis (PrEP). However, the uptake of PrEP in the Arab world is low. In this paper we interviewed female sex workers, physicians who prescribe PrEP, policymakers, and community advocates to identify problems associated with access to and use of PrEP. Several barriers were identified including stigma attached to PrEP, misconceptions about PrEP, and financial burden. Although most female sex workers in our study were interested in using PrEP, the delivery methods of PrEP should be tailored to fit the lifestyle and personal circumstances of potential users.
Publisher
SAGE Publications,SAGE PUBLICATIONS, INC,Sage Publications,SAGE Publishing
Subject
/ Adult
/ Advocacy
/ Anti-HIV Agents - administration & dosage
/ Anti-HIV Agents - therapeutic use
/ Female
/ Females
/ Health Knowledge, Attitudes, Practice
/ Health Services Accessibility - statistics & numerical data
/ HIV
/ HIV Infections - prevention & control
/ Human immunodeficiency virus
/ Humans
/ Male
/ Morocco
/ Original
/ Pre-Exposure Prophylaxis - statistics & numerical data
/ Santé publique et épidémiologie
/ Sex Workers - statistics & numerical data
/ Stigma
