{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T14:10:36Z","timestamp":1784124636439,"version":"3.55.0"},"reference-count":33,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,11,22]],"date-time":"2018-11-22T00:00:00Z","timestamp":1542844800000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1098973"],"award-info":[{"award-number":["OPP1098973"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["ROH\u2010115205"],"award-info":[{"award-number":["ROH\u2010115205"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["FDN\u2010143218"],"award-info":[{"award-number":["FDN\u2010143218"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>In sub\u2010Saharan Africa, <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevalence remains high, especially among key populations. In such situations, combination prevention including clinical, behavioural, structural and biological components, as well as adequate treatment are important. We conducted a demonstration project at the Dispensaire <jats:styled-content style=\"fixed-case\">IST<\/jats:styled-content>, a clinic dedicated to female sex workers (<jats:styled-content style=\"fixed-case\">FSW<\/jats:styled-content>s) in Cotonou, on early antiretroviral therapy (E\u2010<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>, or immediate \u201ctest\u2010and\u2010treat\u201d) and pre\u2010exposure prophylaxis (Pr<jats:styled-content style=\"fixed-case\">EP<\/jats:styled-content>). We present key indicators such as uptake, retention and adherence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective observational study, we recruited FSWs from October 4th 2014 to December 31st 2015 and followed them until December 31st 2016. <jats:styled-content style=\"fixed-case\">FSW<\/jats:styled-content>s were provided with daily tenofovir disoproxil fumarate\/emtricitabine (Truvada<jats:sup>\u00ae<\/jats:sup>) for Pr<jats:styled-content style=\"fixed-case\">EP<\/jats:styled-content> or received a first\u2010line antiretroviral regimen as per Benin guidelines. We used generalized estimating equations to assess trends in adherence and sexual behaviour.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among <jats:styled-content style=\"fixed-case\">FSW<\/jats:styled-content>s in the catchment area, <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> testing coverage within the study framework was 95.5% (422\/442). At baseline, <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevalence was 26.3% (111\/422). Among eligible <jats:styled-content style=\"fixed-case\">FSW<\/jats:styled-content>s, 95.5% (105\/110) were recruited for E\u2010<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> and 88.3% (256\/290) for Pr<jats:styled-content style=\"fixed-case\">EP<\/jats:styled-content>. Overall retention at the end of the study was 59.0% (62\/105) for E\u2010<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> and 47.3% (121\/256) for Pr<jats:styled-content style=\"fixed-case\">EP<\/jats:styled-content>. Mean (\u00b1SD) duration of follow\u2010up was 13.4 (\u00b17.9) months for E\u2010<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> and 11.8 (\u00b17.9) months for PrEP. Self\u2010reported adherence was over 90% among most E\u2010<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> participants. For Pr<jats:styled-content style=\"fixed-case\">EP<\/jats:styled-content>, adherence was lower and the proportion with 100% adherence decreased over time from 78.4% to 56.7% (<jats:italic>p<\/jats:italic>\u2010trend\u00a0&lt;\u00a00.0001). During the 250.1 person\u2010years of follow\u2010up among Pr<jats:styled-content style=\"fixed-case\">EP<\/jats:styled-content> initiators, two seroconversions occurred (incidence 0.8\/100 person\u2010years (95% confidence interval: 0.3 to 1.9\/100 person\u2010years)). The two seroconverters had stopped using Pr<jats:styled-content style=\"fixed-case\">EP<\/jats:styled-content> for at least six months before being found <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected. In both groups, there was no evidence of reduced condom use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study provides data on key indicators for the integration of E\u2010<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> and Pr<jats:styled-content style=\"fixed-case\">EP<\/jats:styled-content> into the <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevention combination package already offered to <jats:styled-content style=\"fixed-case\">FSW<\/jats:styled-content>s in Benin. Pr<jats:styled-content style=\"fixed-case\">EP<\/jats:styled-content> may be more useful as an individual intervention for adherent <jats:styled-content style=\"fixed-case\">FSW<\/jats:styled-content>s rather than a specific public health intervention. E\u2010<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> was a more successful intervention in terms of retention and adherence and is now offered to all key populations in Benin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study registration<\/jats:title><jats:p>ClinicalTrials.gov NCT02237<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25208","type":"journal-article","created":{"date-parts":[[2018,12,3]],"date-time":"2018-12-03T07:20:42Z","timestamp":1543821642000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Early antiretroviral therapy and daily pre\u2010exposure prophylaxis for <scp>HIV<\/scp> prevention among female sex workers in Cotonou, Benin: a prospective observational demonstration study"],"prefix":"10.1002","volume":"21","author":[{"given":"Aminata","family":"Mboup","sequence":"first","affiliation":[{"name":"D\u00e9partement de m\u00e9decine sociale et pr\u00e9ventive Universit\u00e9 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