Title

Willingness to use and preference for long-acting dapivirine vaginal ring for HIV prevention among female sex workers in Vietnam

Presenter

Yen Le

Authors

Y. Le¹, M. Dang^2,3, L. Ngo^2,3, T. Pollack², L. Doan⁴, N. Do⁴, P. Do¹, N.T. Vo^2,3, M. Nguyen⁴, L. Cosimi⁵, H.T. Phan⁴, R. Bhatia⁶

Institutions

¹US Centers for Disease Control and Prevention, Hanoi, Vietnam, ²Beth Israel Deaconess Medical Center, Boston, United States, ³Partnership for Health Advancement in Vietnam, Hanoi, Vietnam, ⁴Vietnam Administration of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam, ⁵Beth Israel Deaconess Medical Center, and The Partnership for Health Advancement in Vietnam and Brigham and Women’s Hospital, Boston, United States, ⁶US Centers for Disease Control and Prevention, Atlanta, USA, Atlanta, United States

BACKGROUND: The long-acting Dapivirine vaginal ring (LA-DVR) was endorsed in the 2021 Vietnam HIV guidelines despite its unavailability in country. There are limited data on LA-DVR in Asia. This study aims to assess the willingness to use and preference for LA-DVR for HIV prevention among female sex workers (FSWs) in Vietnam.
METHODS: Data collection was conducted from July to August 2022 and followed a cross-sectional design. We recruited HIV-negative females aged =18, who reported sex work in past 12 months via purposive sampling through community-based organizations in 4 high-burden provinces in Vietnam. We introduced LA-DVR prior to conducting structured interviews. Descriptive statistics were used.
RESULTS: Among 71 FSWs, mean age was 39 (SD=9.0), and 57.7% had at least secondary education, with average monthly household income of 48USD. In the last 12 months, 56.3% had condomless sex and 42.2% had more than 6 sex partners. Over half (52.1%) had never taken oral PrEP, and 48.7% of these did not know about PrEP. Overall, 53.5% reported definite or probable willingness to use LA-DVR if available. Of those not willing to use LA-DVR, the main reasons were perceived complications and discomfort related to changing it every 28 days (42.4%), effect on sexual intercourse (15.1%), and potential for it to cause vaginal allergies and gynecological diseases (12.1%). When given a choice between oral PrEP and LA-DVR, 36.6% of the overall sample preferred LA-DVR, 49.3% oral, and 11.3% both, with 2.8% choosing neither. FSWs would be more interested in LA-DVR if it contained medicine to prevent pregnancy (77.5%), it could not be felt during sex (69.0%), and they did not have to pay (64.8%).
CONCLUSIONS: Over half of FSWs were definitely or probably willing to use LA-DVR and over one third preferred it to oral PrEP, suggesting that LA-DVR can fill a gap to increase PrEP usage in this key population. LA-DVR uptake may be enhanced by offering it free, co-formulating it with contraception, and addressing main reasons for unwillingness to use. It would be beneficial to increase PrEP literacy and oral PrEP access among FSW while pursuing LA-DVR availability in Vietnam.

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