Accepted for/Published in: JMIR Research Protocols
Date Submitted: Sep 23, 2022
Date Accepted: Apr 3, 2023
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Effectiveness of a community empowerment intervention to improve access to PrEP in migrant female sex workers: a mixed method implementation study protocol
ABSTRACT
Background:
The World Health Organization recommends pre-exposure prophylaxis (PrEP) for all populations at substantial risk of HIV infection. However, at-risk women very rarely use this preventive treatment in France, and it represents a crucial issue in migrant female sex workers (MFSW). Previous studies about PrEP use among female sex workers or migrants have focused on individual or social determinants of motivation. However, there is a lack of operational studies in real-word settings employing a holistic population approach to maximize PrEP adherence among MFSW.
Objective:
The objective of the FASSETS study is to evaluate and describe the effect of the intervention to increase PrEP uptake and to improve global knowledge about sexual health among MFSW, thanks to targeted empowerment strategies based on their needs and preferences.
Methods:
A mixed methods study will be conducted in MFSW in the city of Marseille, France. After a qualitative exploratory phase of the MFSW network, MFSW will be given a unique gift serving as a “capture” and a respondent-driven sampling (RDS) survey will serve as the “recapture”. The capture-recapture method will enable to estimate the total hidden population of MFSW. Approximately 150 RDS participants will be included in a longitudinal cohort for at least one year of follow-up. They will benefit from intensive community empowerment actions together with sequential questionnaires exploring medical history, sexual health, HIV and STD knowledge, migration route and current living conditions. Semi-structured interviews, observations and focus groups will highlight MFSW experiences in empowerment resources, concerns about sexual health and especially PrEP use/uptake. We will evaluate whether and how community-adapted empowerment actions are effective in increasing the use of PrEP in MFSW.
Results:
Recruitment commenced on March 1, 2022. We estimate that the follow-up period will end in March 30, 2023.
Conclusions:
This study will provide rigorous evidence about current access to PrEP and retention in care, and more generally MFSW healthcare pathways through a regular and individual follow-up using a mixed methods analysis. Individual and collective community health empowerment approaches could benefit this vulnerable population to assess PrEP initiation, use, and adherence. Clinical Trial: ANSM-RCB: 2021-A01746-35
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