To inform PrEP roll out, Ashodaya Samithi, a sex workers’ collective, conducted a community-led prospective demonstration project among female sex workers in Mysore and Mandya, India. Following a community preparedness phase and pre-screening, participants were recruited for clinical screening and enrolment, provided PrEP as part of combination HIV prevention, and followed for 16 months. Adherence was measured by self-reported pill intake and by tenofovir blood level testing among a subset of participants. Of the 647 participants enrolled, 640 completed follow-up. Condom use remained stable and no HIV seroconversions occurred. Self-reported daily PrEP intake over the last month was 97.97% at the end of the study. Tenofovir blood levels >40 ng/mL (consistent with steady state dosing) were detected among 80% (n = 68/85) and 90.48% (n = 76/84) of participants at month 3 and 6, respectively. Our study holds important insights for rolling out PrEP in community settings as part of targeted HIV prevention interventions.

community-led, demonstration project, HIV prevention, PrEP, sex work,
Global Public Health
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Department of Public Health

Reza-Paul, S, Lazarus, L. (Lisa), Maiya, R. (Raviprakash), Haldar, P. (Partha), Rewari, B.B. (B. B.), Venugopal, M.S. (M. S.), … Lorway, R. (Robert). (2020). The Ashodaya PrEP project: Lessons and implications for scaling up PrEP from a community-led demonstration project among female sex workers in Mysore, India. Global Public Health. doi:10.1080/17441692.2020.1724316