چکیده (انگلیسی):

In many settings, interventions targeting female sex workers (FSWs) could significantly reduce the overalltransmission of HIV. To understand the role HIV pre-exposure prophylaxis (PrEP) could play in controllingHIV transmission amongst FSWs, it is important to understand how its impact compares with scaling-upcondom use—one of the proven HIV prevention strategies for FSWs. It is important to remember thatcondoms also have other benefits such as reducing the incidence of sexually transmitted infections andpreventing pregnancy. A dynamic deterministic model of HIV transmission amongst FSWs, their clientsand other male partners (termed ‘pimps’) was used to compare the protection provided by PrEP forHIV-negative FSWs with FSWs increasing their condom use with clients and/or pimps. For different HIVprevalence scenarios, levels of pimp interaction, and baseline condom use, we estimated the coverage ofPrEP that gives the same reduction in endemic FSW HIV prevalence or HIV infections averted as differentincreases in condom use. To achieve the same impact on FSW HIV prevalence as increasing condom use by1%, the coverage of PrEP has to increase by >2%. The relative impact of PrEP increases for scenarios wherepimps contribute to HIV transmission, but not greatly, and decreases with higher baseline condom use.In terms of HIV infections averted over 10 years, the relative impact of PrEP compared to condoms wasreduced, with a >3% increase in PrEP coverage achieving the same impact as a 1% increase in condom use.Condom promotion interventions should remain the mainstay HIV prevention strategy for FSWs, withPrEP only being implemented once condom interventions have been maximised or to fill prevention gapswhere condoms cannot be used.© 2015 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-NDlicense (http://creativecommons.org/licenses/by-nc-nd/4.0/).