PrEP knowledge and HIV testing preferences among street-based female sex workers in the United States: Implications post-COVID-19

Female sex workers face a disproportionately high burden of HIV infection globally, yet their knowledge and attitudes towards new HIV prevention methods are understudied in the United States. We conducted focus group discussions and in-depth interviews in a U.S. city among street-based cis- and trans- female sex workers to identify the knowledge, attitudes, and behaviors regarding PrEP and HIV testing in collaboration with a harm-reduction community service organization. We found study participants had limited knowledge of PrEP and poor communication between female sex workers and primary care physicians a barrier to HIV prevention. Participants also expressed strong preferences for HIV testing to be conducted by medical professionals compared to self-testing. Improvement in communication between urban low-income at-risk women and their primary care physicians, and culturally sensitive HIV testing strategies, are critical to the post-COVID-19 strategy on recovery of community services targeting the most vulnerable urban populations.