BACKGROUND Men who have sex with men (MSM), female sex workers (FSW) have critical needs for effective HIV prevention tools. This study identified perspectives of MSM, FSW and policy makers on the needs for, barriers to, and challenges with pre-exposure HIV prophylaxis (PrEP); and the logistics required to support roll-out of PrEP for MSM and FSW in Nigeria. METHODS Qualitative and quantitative data were collected through a cross-sectional study. The quantitative data were collected through an online survey administered to 519 MSM, FSW and transgender respondents. The qualitative data were collected through 22 focus group discussions with 140 MSM and 80 FSW, and a two-day consultative workshop with 65 participants. Two open-ended questions in the online survey were also a source of qualitative data. Results of the quantitative data were reported descriptively; the qualitative data were inductively examined with a content analytic approach to construct descriptive categories. The findings from the quantitative and qualitative responses were triangulated. RESULTS Four hundred and ninety-four (95.2%) online respondents had heard about PrEP through community dialogue (71.3%), and 439 (84.6%) supported its use by MSM and FSW. Fewer than half of the respondents were aware of the clinical care required for PrEP, and misconceptions about PrEP were common. Stated barriers to PrEP uptake were stigma, cost, frequency of HIV counseling and treatment services required, and possible drug-drug interactions. Concerns included possible condom migration, increased risk for sexually transmitted infections and pregnancy for FSW, and poor adherence to medication and hospital schedules. Participants felt that trained peer educators and HIV-test counselors could provide information and refer clients to clinics that provide PrEP. PrEP can be provided through peer-led facilities for MSM and FSW, though its access should be expanded to all persons who are at substantial risk for HIV to prevent negative labeling of PrEP. Public awareness about the use of antiretrovirals for HIV prevention is needed to prevent labeling of PrEP users as being HIV positive. CONCLUSION Although MSM and FSW are interested in the use of PrEP, numerous individual and structural barriers need to be addressed to facilitate access to it in Nigeria.

中文翻译：

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社区对尼日利亚男男性接触者和女性性工作者获取艾滋病毒前接触预防途径的障碍和挑战的看法。

背景技术与男性发生性关系的男性（MSM）和女性性工作者（FSW）对有效的艾滋病毒预防工具有迫切的需求。这项研究确定了MSM，FSW和决策者对暴露前HIV预防（PrEP）的需求，障碍和挑战的观点；以及支持在尼日利亚为MSM和FSW推出PrEP所需的物流。方法通过横断面研究收集定性和定量数据。通过对519名MSM，FSW和跨性别受访者进行的在线调查收集了定量数据。定性数据是通过与140个MSM和80个FSW进行的22个焦点小组讨论以及65个参与者的为期两天的咨询研讨会而收集的。在线调查中的两个开放性问题也是定性数据的来源。描述性地报告了定量数据的结果；使用内容分析方法归纳检查定性数据以构建描述性类别。定量和定性反应的发现被三角化。结果494位在线受访者（95.2％）通过社区对话听说过PrEP（占71.3％），而439位受访者（84.6％）支持MSM和FSW使用它。不到一半的受访者知道PrEP需要临床护理，并且对PrEP的误解很普遍。陈述的PrEP摄取障碍包括污名，费用，所需的HIV咨询和治疗服务频率以及可能的药物相互作用。问题包括安全套可能迁移，性传播感染的风险增加以及FSW怀孕，对药物和医院时间表的依从性差。与会者认为，受过训练的同伴教育者和艾滋病毒检测顾问可以提供信息，并将客户介绍给提供PrEP的诊所。可以通过同行领导的设施为男男性接触者和FSW提供PrEP，但应将其访问权限扩大到所有具有HIV重大风险的人，以防止对PrEP进行负面标记。需要公众意识到使用抗逆转录病毒药物预防艾滋病毒，以防止将PrEP使用者标记为艾滋病毒呈阳性。结论尽管MSM和FSW对使用PrEP感兴趣，但仍需要解决许多个人和结构性障碍，以便利在尼日利亚使用PrEP。与会者认为，受过训练的同伴教育者和艾滋病毒检测顾问可以提供信息，并将客户介绍给提供PrEP的诊所。可以通过同行领导的设施为男男性接触者和FSW提供PrEP，但应将其访问范围扩大到所有具有HIV重大风险的人，以防止对PrEP进行负面标记。需要公众对使用抗逆转录病毒药物预防艾滋病毒的认识，以防止将PrEP使用者标记为艾滋病毒呈阳性。结论尽管MSM和FSW对使用PrEP感兴趣，但仍需要解决许多个人和结构性障碍，以便利在尼日利亚使用PrEP。与会者认为，受过训练的同伴教育者和艾滋病毒检测顾问可以提供信息，并将客户介绍给提供PrEP的诊所。可以通过同行领导的设施为男男性接触者和FSW提供PrEP，但应将其访问权限扩大到所有具有HIV重大风险的人，以防止对PrEP进行负面标记。需要公众对使用抗逆转录病毒药物预防艾滋病毒的认识，以防止将PrEP使用者标记为艾滋病毒呈阳性。结论尽管MSM和FSW对使用PrEP感兴趣，但仍需要解决许多个人和结构性障碍，以便利在尼日利亚使用PrEP。需要公众意识到使用抗逆转录病毒药物预防艾滋病毒，以防止将PrEP使用者标记为艾滋病毒呈阳性。结论尽管MSM和FSW对使用PrEP感兴趣，但仍需要解决许多个人和结构性障碍，以便利在尼日利亚使用PrEP。需要公众意识到使用抗逆转录病毒药物预防艾滋病毒，以防止将PrEP使用者标记为艾滋病毒呈阳性。结论尽管MSM和FSW对使用PrEP感兴趣，但仍需要解决许多个人和结构性障碍，以便利在尼日利亚使用PrEP。