title: The promise and peril of pre-exposure prophylaxis (PrEP): using social science to inform prep interventions among female sex workers.
abstract: Advances in biomedical interventions to prevent HIV offer great promise in reducing the number of new infections across sub- Saharan Africa, particularly among vulnerable populations such as female sex workers. Several recent trials testing pre-exposure prophylaxis (PrEP) have demonstrated efficacy, although others have been stopped early for futility. Given the importance and complexities of social and behavioural factors that influence biomedical approaches to prevention, we discuss several key areas of consideration moving forward, including trial participation, adherence strategies, social relationships, and the structural factors that shape PrEP interest, use, and potential effectiveness among female sex workers in sub-Saharan Africa. Our review highlights the importance of involving social scientists in clinical and community-based research on PrEP. We advocate for a shift away from a singular "re-medicalization" of the HIV epidemic to that of a "reintegration" of interdisciplinary approaches to prevention that could benefit female sex workers and other key populations at risk of acquiring HIV.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Syvertsen
authors.forename: Angela M
authors.initials: AM
authors.lastname: Robertson Bazzi
authors.forename: Andrew
authors.initials: A
authors.lastname: Scheibe
authors.forename: Sylvia
authors.initials: S
authors.lastname: Adebajo
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
authors.forename: Wendee M
authors.initials: WM
authors.lastname: Wechsberg
mesh_terms: D017954:Africa South of the Sahara; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology; D006801:Humans; D007398:Interpersonal Relations; D010349:Patient Compliance; D065129:Pre-Exposure Prophylaxis / Q000379:methods*; D012106:Research / Q000458:organization & administration*; D035842:Research Subjects; D060386:Sex Workers; D012942:Social Sciences / Q000458:organization & administration*; D012944:Social Support; D035862:Vulnerable Populations