{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T06:11:08Z","timestamp":1781417468535,"version":"3.54.1"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Female sex workers (FSWs) are at an elevated risk of HIV infection with an eight-fold risk of HIV infection. In countries like Zimbabwe, FSWs have an HIV incidence of around 10.2%. With this elevated risk, the World Health Organization has prioritized Female sex workers (FSWS) for PrEP \u2013 an HIV prevention option taken as a daily pill during periods of risk but, FSWs continue to experience challenges with daily PrEP adherence due to daily dosing, related side effects, ARV stigma and low risk perception. This article presents the FSWs\u2019 lived experiences with PrEP adherence in Zimbabwe.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We purposively identified twenty FSWs and conducted individual interviews to understand FSW lived experiences with PrEP adherence. We applied Colaizzi\u2019s seven steps of phenomenological analysis to develop the themes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Findings<\/jats:title>\n<jats:p>Three main themes emerged, namely positive experiences with PrEP adherence, negative experiences with PrEP adherence and the meaning attached to PrEP adherence. The positive experiences theme had four sub-themes as, overcoming PrEP-related forgetfulness, overcoming mobility-related PrEP disruptions, overcoming COVID-19 pandemic-related PrEP experiences and overcoming PrEP-related side effects. The negative experiences theme had two sub-themes including, enduring GBV and stigma associated with PrEP use and, COVID-19-related disruptions to PrEP adherence. The third emerging them was on the meaning attached to PrEP adherence. This theme had one sub-theme on PrEP adherence as a survival strategy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Whilst FSWs reported both positive and negative experiences with PrEP adherence, it is important that FSWs used the meaning they attached to these experiences to take control of their lives and be more determined to use PrEP adherence for survival and protection from HIV. Based on these findings, we recommend close monitoring and support to promote adherence, minimize PrEP discontinuity and promote positive lived experiences with PrEP adherence.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0313366","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T17:30:32Z","timestamp":1757007032000},"page":"e0313366","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["A qualitative analysis of female sex workers\u2019 lived experiences with adherence to Pre-exposure Prophylaxis (PrEP) in Zimbabwe"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6058-5237","authenticated-orcid":true,"given":"Definate","family":"Nhamo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dixon","family":"Chibanda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances M.","family":"Cowan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2489-8770","authenticated-orcid":true,"given":"Sinegugu E.","family":"Duma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"key":"pone.0313366.ref001","author":"UNAIDS","year":"2024","journal-title":"The Urgency of Now"},{"key":"pone.0313366.ref002","doi-asserted-by":"crossref","DOI":"10.1097\/QAI.0000000000003344","article-title":"Updated Data and Methods for the 2023 UNAIDS HIV Estimates","volume":"95","author":"C van Schalkwyk","year":"2024","journal-title":"J Acquir Immune Defic Syndr"},{"key":"pone.0313366.ref003","journal-title":"\u201cconsolidated guidelines 2016.pdf.\u201d"},{"issue":"7","key":"pone.0313366.ref004","doi-asserted-by":"crossref","DOI":"10.1016\/S2352-3018(23)00110-8","article-title":"Temporal trends in, and risk factors for, HIV seroconversion among female sex workers accessing Zimbabwe\u2019s national sex worker programme, 2009\u201319: a retrospective cohort analysis of routinely collected HIV testing data","volume":"10","author":"HS Jones","year":"2023","journal-title":"Lancet HIV"},{"issue":"1","key":"pone.0313366.ref005","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s12981-020-00327-7","article-title":"Pre-exposure prophylaxis makes it possible to better live one\u2019s sexuality and guide men who have sex with men towards a responsible approach to their health: a phenomenological qualitative study about primary motivations for PrEP","volume":"18","author":"M Bistoquet","year":"2021","journal-title":"AIDS Res Ther"},{"issue":"1","key":"pone.0313366.ref006","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1186\/s12889-021-10766-0","article-title":"PrEP reminds me that I am the one to take responsibility of my life: a qualitative study exploring experiences of and attitudes towards pre-exposure prophylaxis use by women in Eswatini","volume":"21","author":"PJ Bjertrup","year":"2021","journal-title":"BMC Public Health"},{"issue":"7","key":"pone.0313366.ref007","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1007\/s10461-015-1055-5","article-title":"Sexual Behavior, Risk Compensation, and HIV Prevention Strategies Among Participants in the San Francisco PrEP Demonstration Project: A Qualitative Analysis of Counseling Notes","volume":"20","author":"J Carlo Hojilla","year":"2016","journal-title":"AIDS Behav"},{"issue":"3","key":"pone.0313366.ref008","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0248307","article-title":"Experiences of oral pre-exposure prophylaxis (PrEP) use disclosure among South African adolescent girls and young women and its perceived impact on adherence","volume":"16","author":"D Giovenco","year":"2021","journal-title":"PLoS One"},{"issue":"8","key":"pone.0313366.ref009","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1080\/13691058.2020.1752398","article-title":"How current and potential pre-exposure prophylaxis (PrEP) users experience, negotiate and manage stigma: disclosures and backstage processes in online discourse","volume":"23","author":"AM Hedrick","year":"2021","journal-title":"Cult Health Sex"},{"key":"pone.0313366.ref010","article-title":"Understanding the PrEP care continuum for adults: Health care providers\u2019 perspectives on barriers, facilitators, and missed opportunities","author":"C Zhang","year":"2025","journal-title":"AIDS Patient Care STDS"},{"issue":"1","key":"pone.0313366.ref011","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1186\/s12879-018-3463-4","article-title":"A systematic review of adherence to oral pre-exposure prophylaxis for HIV - 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