Examining the Implications of PrEP as HIV Prevention for Sex Workers

Some people do not want to use condoms – because they want to conceive or they perceive that they are a barrier to intimacy. New medication to prevent HIV, known as pre-exposure prophylaxis (PrEP), could provide protection where condoms are not used. Integrating it into HIV and sexual health programming for various communities has become a focus of researchers and health and development agencies. However, PrEP raises important challenges in the context of female sex work.* To protect sexual and reproductive health and avoid pregnancy, PrEP must be used with condoms but that may be difficult where clients perceive PrEP as an alternative. Frequent HIV testing and medicalisation of HIV prevention in low-income settings presents challenges for those who lack the rights and power needed to make informed health-related decisions. Policymakers and HIV agencies have a short window in which to ensure that PrEP complements existing programming and plan ways to avert potential negative impacts.