@article{fdi:010078925, title = {{S}exual health needs of female sex workers in {C}ote d'{I}voire : a mixed-methods study to prepare the future implementation of pre-exposure prophylaxis ({P}r{EP}) for {HIV} prevention}, author = {{B}ecquet, {V}alentine and {N}ouaman, {M}. and {P}lazy, {M}. and {M}asumbuko, {J}. {M}. and {A}noma, {C}. and {K}ouame, {S}. and {D}anel, {C}. and {E}holie, {S}. {P}. and {L}armarange, {J}oseph and {ANRS} 12361 {P}r{EP}-{CI} {S}tudy {G}roup}, editor = {}, language = {{ENG}}, abstract = {{O}bjective {T}o describe sexual and reproductive health ({SRH}) needs of female sex workers ({FSW}s) to inform the future implementation of pre-exposure prophylaxis ({P}r{EP}) for {HIV} prevention in this population. {D}esign and setting {T}he {ANRS} 12361 {P}r{EP}-{CI} cross-sectional and mixed-methods study was designed and implemented with two community-based organisations in {C}ote d'{I}voire. {P}articipants {A} convenience sample of 1000 {FSW}s aged >= 18, not known as {HIV}-positive, completed a standardised questionnaire assessing sociodemographic characteristics, sexual practices, use of community health services and a priori acceptability of {P}r{EP}. {T}wenty-two indepth interviews and eight focus group discussions were also conducted to document {FSW}s' risky practices and sexual behaviours, experiences with violence and discrimination, attitudes regarding {HIV} and sexually transmitted infections ({STI}s), and barriers to {SRH} services. {R}esults {A}lthough 87% described consistent condom use with clients, more than 22% declared accepting condomless sexual intercourse for a large sum of money. {F}urthermore, condom use with their steady partner and knowledge of their partner's {HIV} status were low despite their acknowledged concurrent sexual partnerships. {W}hile inconsistent condom use exposed {FSW}s to {STI}s and undesired pregnancies, the prevalence of contraceptive strategies other than condoms was low (39%) due to fear of contraception causing sterility. {FSW}s faced obstacles to accessing {SRH} care and preferred advice from their peers or self-medication. {C}onclusions {D}espite adoption of preventive behaviour in most cases, {FSW}s are still highly exposed to {HIV}. {F}urthermore, {FSW}s seem to face several barriers to accessing {SRH}. {I}mplementing {P}r{EP} among {FSW}s in {W}est {A}frica, such as in {C}ote d'{I}voire, constitutes an opportunity to consider the regular follow-up of {HIV}-negative {FSW}s. {P}r{EP} initiation should not condition access to {SRH} services; conversely, {SRH} services could be a way to attract {FSW}s into {HIV} prevention. {O}ur results highlight the importance of developing a people-focused approach that integrates all {SRH} needs when transitioning from {P}r{EP} efficacy trials to implementation.}, keywords = {qualitative research ; {HIV} & {AIDS} ; public health ; demography ; epidemiology ; {COTE} {D}'{IVOIRE}}, booktitle = {}, journal = {{BMJ} {O}pen}, volume = {10}, numero = {1}, pages = {e028508 [12 ]}, ISSN = {2044-6055}, year = {2020}, DOI = {10.1136/bmjopen-2018-028508}, URL = {https://www.documentation.ird.fr/hor/fdi:010078925}, }