“I’M AFRAID OF GETTING HIV”: RISK PERCEPTIONS AND PREP ADHERENCE AMONG YOUNG FEMALE SEX WORKERS IN MAPUTO CITY, MOZAMBIQUE

Abstract

Introduction: In Mozambique, the Ministry of Health recommends Pre-exposure prophylaxis (PrEP) combined with condom use to prevent HIV infection in people at high risk, including young female sex workers (YFSWs). However, adherence to this prevention method remains low, and little is known about how YFSWs perceive PrEP and the values ​​that guide their decisions to use it. This study qualitatively analyzed the relationship between perceptions of HIV risk and acceptance of, and adherence to, PrEP among YFSW in Maputo City, Mozambique.Methods: This qualitative case study was conducted between June and September 2024. It consisted of 52 in-depth interviews and five focus group discussions with YFSWs, as well as 44 semi-structured interviews with healthcare providers. The interviews were analyzed using thematic analysis. Results: The narratives indicated that not all YFSWs use PrEP. Those who do use this method perceive PrEP as an HIV prevention mechanism, especially as an alternative when negotiating condom use with clients becomes difficult. However, some YFSWs reported not using PrEP due to factors such as social stigma related to HIV, difficulties in accessing the medication, and a lack of accurate information about this prophylaxis.Conclusion: Acceptance of, and adherence to, PrEP is influenced not only by the perception of HIV infection risk, but also by individual, structural, and contextual factors in which YFSWs live. Strategies that integrate health education, combat stigma, and improve access to medication are necessary to promote sustainable PrEP adherence.