Sexual health knowledge, interest and acceptability of preexposure prophylaxis in migrant women

Objectives: Migrant women often experience difficulties in accessing sexual healthcare services. We assess the knowledge and acceptability of preexposure prophylaxis (PrEP) in migrant women. Methods: We carried out a survey exploring HIV and PrEP knowledge in a cohort of adult migrant women residing in Padua (Italy). Subsequently, women were counselled about PrEP, screened for sexually transmitted infections (STIs) and asked about PrEP acceptability. We assessed factors correlating with PrEP acceptability using logistic regression. Results: Two hundred and twenty-one migrant women were included, mostly Nigerian (122, 55.2%), asylum seekers (78, 35.3%), with a low level of education (179, 81%), with a median age of 31 [interquartile range (IQR): 26-37] years and a median time in Italy of 59 months (IQR: 16-82). Of these, 86% disclosed a regular sexual activity, 17.4% reported to have experienced nonconsensual sexual intercourse, and 9.5% to have been paid for sex. Only 14.5% disclosed to regularly use condoms during sexual intercourse. Since their arrival in Italy, 35.7% had undergone a gynaecological examination, and 50.2% had received a STI screening. 85.5% women did not know how to access contraception, and 28.5% knew about PrEP. After counselling, 16.7% women said they would accept PrEP. PrEP acceptability was associated with living in an asylum seeker centre [adjusted odds ratio (AdjOR): 0.08, P  = 0.03], international protection status (AdjOR: 4.98, P  = 0.041), and natural contraception use (AdjOR: 5.27, P  = 0.024). Conclusion: Sexual health awareness/care and PrEP uptake in migrant women were low and highlighted the urgency of tackling the HIV/STI risk in this vulnerable population, by adopting specific outreach programmes and ensuring they receive information, support, and empowerment about options to make their sexual health safer.