As ART-based prevention becomes available,
effectively targeting these interventions to key populations
such as female sex workers (FSW) will be critical. In this
study we analyze patterns of repeated post-exposure prophylaxis
(PEP) access in the context of a large FSW program
in Nairobi. During close to 6000 person-years of
follow-up, 20 % of participants (n = 1119) requested PEP
at least once and 3.7 % requested PEP more than once.
Repeat PEP users were younger, had a higher casual
partner volume, and were more likely to use condoms with
casual and regular partners, have a regular partner, and test
for HIV prior to enrolment. Barriers to PEP included
stigma, side effects, and lack of knowledge, suggesting
repeated promotion may be required for higher rates of
uptake. A small subset of FSW, potentially those with
heightened risk perception, showed a higher frequency of
PEP use; these individuals may be most amenable to rollout
of pre-exposure prophylaxis.