Pre-Exposure Prophylaxis Use Among Cisgender and Transgender Adult Entertainment Workers in Brazil

Policardo Gonçalves da Silva, Lariane Angel Cepas, Isadora Silva de Carvalho, Álvaro Francisco Lopes de Sousa (), Guilherme Reis de Santana Santos, Caíque Jordan Nunes Ribeiro and Ana Paula Morais Fernandes
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Policardo Gonçalves da Silva: Department of General and Specialized Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-903, SP, Brazil
Lariane Angel Cepas: Department of General and Specialized Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-903, SP, Brazil
Isadora Silva de Carvalho: Department of General and Specialized Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-903, SP, Brazil
Álvaro Francisco Lopes de Sousa: Institute of Teaching and Research, Hospital Sírio-Libanês, São Paulo 01308-050, SP, Brazil
Guilherme Reis de Santana Santos: Graduate Program in Applied Health Sciences, Federal University of Sergipe, Lagarto 49406-584, SE, Brazil
Caíque Jordan Nunes Ribeiro: Graduate Program in Nursing, Federal University of Sergipe, São Cristóvão 49107-230, SE, Brazil
Ana Paula Morais Fernandes: Department of General and Specialized Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-903, SP, Brazil

IJERPH, 2025, vol. 22, issue 8, 1-16

Abstract: Adult entertainment work may be associated with increased vulnerability to sexually transmitted infections, particularly HIV. In Brazil, pre-exposure prophylaxis (PrEP) for HIV infection has been available through the Brazilian Unified Health System (SUS) since November 2017, representing a significant advancement in public sexual health policy. The objective of this study was to understand the individual and social determinants that promote PrEP use among adult entertainment workers. This was a cross-sectional, analytical, and quantitative study. A multivariate modeling approach was employed to identify factors independently associated with PrEP use. The study included 254 adult entertainment workers using oral PrEP through the SUS, predominantly young adults (141; 55.5%), SUS users (248; 97.6%), single (213; 83.9%), non-white (142; 55.9%), cisgender (148; 58.3%), and heterosexual (152; 59.8%). Factors independently associated with greater PrEP use included having adult entertainment as the main source of income (aPR: 2.69; 95% CI: 1.86–3.95), prior use of PEP (aPR: 2.49; 95% CI: 1.63–3.81), undergoing any type of health treatment (aPR: 1.56; 95% CI: 1.15–2.12), and having a history of STIs (aPR: 1.51; 95% CI: 1.10–2.08). Conclusion: PrEP use in this population was strongly influenced by structural and contextual factors, indicating that the availability of the technology alone does not ensure its effectiveness.

Keywords: pre-exposure prophylaxis; sex workers; Brazilian unified health system; sexual health; HIV (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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