ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Education and Promotion
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1544080
This article is part of the Research TopicReproductive Infectious Diseases: Matters Across the Spectrum of Reproductive HealthView all 6 articles
Assessment of Awareness and Willingness to Use Pre-Exposure Prophylaxis for HIV Prevention among Female Sex Workers in Rwanda: A cross sectional study
Provisionally accepted
Albert Nzungize1
Athanase Munyaneza2,3*- 1King Faisal Hospital-Rwanda, Gasabo, Kigali City, Rwanda
- 2School of Public Health, University of Rwanda., Kigali, Rwanda
- 3Research for Development, Rwanda (RD Rwanda), Kigali, Rwanda
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Female sex workers (FSWs) in sub-Saharan Africa carry a high burden of HIV risk. Although pre-exposure prophylaxis (PrEP) is increasingly available, data on FSWs' awareness and willingness to use it remain limited. This study assessed PrEP awareness, willingness to use it, and associated factors among FSWs in Kigali, Rwanda. A cross-sectional survey was conducted from April to September 2024 among 333 FSWs aged 18 and older, recruited through community-based FSW associations using stratified random sampling. Data were analyzed using SPSS, and logistic regression was applied to identify factors associated with awareness and willingness. Ethical approval was obtained from the Rwanda National Ethics Committee. Participants had a mean age of 30 years (SD: 7.26); 47% were aged 25–34. Most were single (67%) and unemployed (66%), with 49.5% reporting only primary education. A majority (81%) had tested for HIV in the previous six months, and 50% had been involved in sex work for 2–5 years. The median number of sexual partners in the past week was seven. PrEP awareness was high (81%). However, consistent condom users were less likely to be aware of PrEP (adjusted odds ratio [aOR]: 0.40, 95% CI: 0.19–0.83), as were those not screened for sexually transmitted infections (STIs) (aOR: 0.43, 95% CI: 0.22–0.85). Willingness to use PrEP was reported by 80% of participants. Those with a primary education were more willing to use PrEP than those with no formal education (aOR: 4.09, 95% CI: 1.62–10.33), while those screened for STIs were less willing than those not screened (aOR: 0.28, 95% CI: 0.12–0.62). This study highlights high levels of PrEP awareness and willingness among FSWs in Kigali, but also reveals gaps among consistent condom users and those screened for STIs. Findings emphasize the need for targeted education and outreach to improve PrEP uptake and support comprehensive HIV prevention strategies among FSWs.
Keywords: assessment, Awareness, Willingness to use PrEP, Female sex workers, Kigali, Rwanda
Received: 12 Dec 2024; Accepted: 08 Aug 2025.
Copyright: © 2025 Nzungize and Munyaneza. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Athanase Munyaneza, School of Public Health, University of Rwanda., Kigali, Rwanda
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