There is scant knowledge regarding pre-exposure prophylaxis (PrEP) use among female sex workers (FSWs) in Europe. Spain recognized FSWs as a population at high risk of acquiring HIV and granted them subsidized access to PrEP when the medication first became nationally available in 2019. Nevertheless, FSWs represented just 0.2% of PrEP users in 2022. A total of 102 HIV-negative FSWs reached through field activities of local NGOs located in Madrid were interviewed between January and March 2022. Participants were selected through convenience sampling over a fixed recruitment period. FSWs completed a 73-item survey with questions about individual, occupational, social, and structural determinants. The objective of this study was to identify (1) the prevalence of intention to use oral PrEP and its determinants, and (2) the prevalence of inconsistent condom use, which is the risk factor that qualifies FSWs for subsidized PrEP in the national health system, and its determinants. Importantly, the study sample overrepresented street-based FSWs (71.6%). A quarter (25.5%) of the study participants used condoms inconsistently. PrEP awareness was low (9.8%), but intention to use PrEP was high (72.5%). Intention to use oral PrEP was significantly associated with feeling protected against HIV by taking PrEP and perceiving insufficient protection by condom use alone. Inconsistent condom use was significantly associated with frequent heroin/cocaine use, having clients who inject drugs, and willingness to take PrEP despite it not protecting 100% against HIV infection. FSWs, in this specific sample, are likely to benefit from targeted PrEP awareness campaigns and implementation projects that prioritize those who use drugs and are more likely to engage in condomless sex.

对于欧洲女性性工作者 (FSW) 中暴露前预防 (PrEP) 的使用知之甚少。西班牙承认 FSW 是感染 HIV 的高风险人群，并在 2019 年首次在全国范围内提供药物时向他们提供 PrEP 补贴。尽管如此，到 2022 年，FSW 仅占 PrEP 用户的 0.2%。共有 102 名 HIV 阴性 FSW 2022 年 1 月至 3 月期间，我们对马德里当地非政府组织的实地活动进行了采访。参与者是在固定招募期内通过便利抽样选出的。 FSW 完成了一项包含 73 项的调查，其中包含有关个人、职业、社会和结构决定因素的问题。本研究的目的是确定 (1) 使用口服 PrEP 的意愿及其决定因素，以及 (2) 不一致使用安全套的普遍程度，这是使 FSW 有资格在国家卫生系统中享受 PrEP 补贴的风险因素，及其决定因素。重要的是，研究样本过多地代表了街头 FSW（71.6%）。四分之一（25.5%）的研究参与者不一致地使用安全套。 PrEP 知晓率较低（9.8%），但使用 PrEP 的意愿较高（72.5%）。使用口服 PrEP 的意愿与通过服用 PrEP 来预防 HIV 的感觉显着相关，并且认为单独使用安全套的保护不足。安全套使用不一致与频繁使用海洛因/可卡因、有注射毒品的客户以及愿意接受 PrEP 显着相关，尽管 PrEP 不能 100% 防止 HIV 感染。在这个特定样本中，FSW 可能会受益于有针对性的 PrEP 宣传活动和实施项目，这些活动和实施项目优先考虑那些吸毒且更有可能进行无套性行为的人。