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Pre\u2010exposure prophylaxis (PrEP) is highly efficacious for HIV prevention. It represents a promising strategy to reduce HIV acquisition risks among FSWs specifically given complex social and structural factors that challenge consistent condom use. However, the potential impact on unintended pregnancy has garnered little attention. We discuss the potential concerns and opportunities for PrEP to positively or negatively impact the sexual and reproductive health and rights (SRHR) of FSWs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>FSWs have high unmet need for effective contraception and unintended pregnancy is common in low\u2010 and middle\u2010income countries. Unintended pregnancy can have enduring health and social effects for FSWs, including consequences of unsafe abortion and financial impacts affecting subsequent risk\u2010taking. It is possible that PrEP could negatively impact condom and other contraceptive use among FSWs due to condom substitution, normalization, external pressures or PrEP provision by single\u2010focus services. There are limited empirical data available to assess the impact of PrEP on pregnancy rates in real\u2010life settings. However, pregnancy rates are relatively high in PrEP trials and modelling suggests a potential two\u2010fold increase in condomless sex among FSWs on PrEP, which, given low use of non\u2010barrier contraceptive methods, would increase rates of unintended pregnancy. Opportunities for integrating family planning with PrEP and HIV services may circumvent these concerns and support improved SRHR. Synergies between PrEP and family planning could promote uptake and maintenance for both interventions. Integrating family planning into FSW\u2010focused community\u2010based HIV services is likely to be the most effective model for improving access to non\u2010barrier contraception among FSWs. However, barriers to integration, such as provider skills and training and funding mechanisms, need to be addressed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>As PrEP is scaled up among FSWs, there is growing impetus to consider integrating family planning services with PrEP delivery in order to better meet the diverse SRHR needs of FSWs and to prevent unintended consequences. Programme monitoring combined with research can close data gaps and mobilize adequate resources to deliver comprehensive SRHR services respectful of all women\u2019s rights.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25442","type":"journal-article","created":{"date-parts":[[2020,2,17]],"date-time":"2020-02-17T09:57:41Z","timestamp":1581933461000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["HIV pre\u2010exposure prophylaxis for female sex workers: ensuring women\u2019s family planning needs are not left behind"],"prefix":"10.1002","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2192-9260","authenticated-orcid":false,"given":"Anna L","family":"Bowring","sequence":"first","affiliation":[{"name":"Department of Epidemiology Johns Hopkins School of Public Health Baltimore MD USA"},{"name":"Burnet Institute Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frances H","family":"Ampt","sequence":"additional","affiliation":[{"name":"Burnet Institute Melbourne Victoria Australia"},{"name":"Department of Epidemiology and Preventive Medicine Monash University Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheree","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins School of Public Health Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark A","family":"Stoov\u00e9","sequence":"additional","affiliation":[{"name":"Burnet Institute Melbourne Victoria Australia"},{"name":"Department of Epidemiology and Preventive Medicine Monash University Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanley","family":"Luchters","sequence":"additional","affiliation":[{"name":"Burnet Institute Melbourne Victoria Australia"},{"name":"Department of Epidemiology and Preventive Medicine Monash University Melbourne Victoria Australia"},{"name":"Department of Population Health Aga Khan University Nairobi Kenya"},{"name":"International Centre for Reproductive Health Department of Public Health and Primary Care Ghent University Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5482-2419","authenticated-orcid":false,"given":"Stefan","family":"Baral","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins School of Public Health Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Hellard","sequence":"additional","affiliation":[{"name":"Burnet Institute Melbourne Victoria Australia"},{"name":"Department of Epidemiology and Preventive Medicine Monash University Melbourne Victoria Australia"},{"name":"Department of Infectious Diseases The Alfred Hospital Melbourne Victoria Australia"},{"name":"Doherty Institute and Melbourne School of Population and Global Health University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,2,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(12)70066-X"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-021779"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1744-8603-10-46"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1744-8603-10-47"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/792649"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/jfprhc-2014-100968"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-017-0277-6"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1363\/intsexrephea.41.4.0182"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000215"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60974-0"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-012-0317-8"},{"key":"e_1_2_7_13_1","unstructured":"EakleR BothmaR BourneA GumedeS MotsosiK ReesH et al.The PrEP life: Female sex workers' perspectives on uptake and use of daily pre\u2010exposure prophylaxis for HIV prevention in South Africa. 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