Knowledge, attitude and practice of post exposure prophylaxis among female sex workers at Majengo, Nairobi

Abstract

Background: HIV Post-exposure prophylaxis (PEP) is defined as the provision of a short course of antiretroviral drugs soon after a possible or confirmed HIV exposure to HIV negative persons. The aim is to allow a person’s immune system to provide protection against the virus and to prevent HIV from becoming established in someone’s body. However, its use in at*risk populations such as female sex workers has not been studied extensively.

Objectives: The main objective of the study was to determine knowledge, attitude and practice in particular use of post exposure prophylaxis among the female sex workers.

Study Design: Descriptive cross-sectional survey was carried out at the female sex worker clinic located at Majengo slums, Nairobi.

Method: Consecutive sampling method was used to identify study population and 345 participants were sampled and interviewed using semi*structured questionnaire.

Results: The average age of the participants was between (25*34years). The mean duration of prostitution was 10 years. The mean number of all type of sexual clients per week was 11.4 (CI: 10.6*12.2). Condom use was high among irregular clients (>90%) as compared to regular clients/boyfriends (6.8%). On sexual practice the study showed that vaginal sex was highly practiced among all sexual clients (90%). The study revealed that 75.7% of the participants had adequate knowledge on PEP. Though 71% of the participants had ever used PEP, majority (68.9%) did not complete the four weeks of treatment. Out of the participants who had ever used EP, 10.3% had used it due to rape and 65.3% condom burst (P<0.01) and 24.4% had used it because they either chose not to use condom or they were paid more not to use condoms The study demonstrated that side effects of drugs (57.4%) and fear of being known that they were using PEP (64.1%) positively affected the uptake of Post exposure prophylaxis.

Conclusion: The study demonstrated that the participants adopted safer sexual behaviour which included condom use though more education is needed to use protection even with the boyfriends/regular clients. Most of the participants reported that the reason for PEP use as due to condom burst, there was need for health providers to do health education on proper condom use and the recommended lubricants including demonstration from time to time to avoid condom burst. The results also showed that the study participants rarely practiced risky sexual behaviour like anal sex. The study revealed that 23.4% of the participants had inadequate knowledge on PEP. The major constraint to PEP uptake was side effects and fear that other clients will know that they are on PEP hence there is need for more interventions on PEP in order to increase the level of awareness and adherence.