Correlates of HIV pre-exposure prophylaxis (PrEP) uptake among female sex workers in northern Nigeria

Background Female sex workers (FSWs) face a disproportionately high risk of HIV acquisition, yet uptake of pre-exposure prophylaxis (PrEP) remains low in many settings. We examined PrEP awareness, utilization, and adherence, and identified predictors of uptake among FSWs engaged through One-Stop-Shop (OSS)-linked urban venues in Nigeria. Methods A cross-sectional survey was conducted among 146 FSWs using venue-based time-location sampling. Structured, interviewer-administered questionnaires assessed socio-demographic characteristics, PrEP knowledge and use, and exposure to HIV prevention services. Multivariate logistic regression was used to identify independent predictors of PrEP uptake. Results PrEP awareness was high (76.7%), and among those aware, 92.0% had ever used PrEP. However, adherence was inconsistent: only 41.7% reported daily use, while the majority reported irregular or on-demand use. Peer educators and community-based HIV prevention workers were the most common information sources (69.6%). After adjusting for potential confounders, only participation in group sessions remained a significant independent predictor of PrEP uptake (adjusted Odds Ratio, aOR = 14.22; 95% confidence interval, CI: 1.44–31.61). Conclusions FSWs linked to urban OSS platforms in Nigeria demonstrated high levels of PrEP awareness and use. The emergence of group HIV prevention sessions as an independent predictor of PrEP uptake reinforces the value of peer-led, community-based behavioral interventions in this setting.