Full-service sex workers (FSSW) are individuals who exchange direct sexual services for goods, money, or other services (Centers for Disease... Show moreFull-service sex workers (FSSW) are individuals who exchange direct sexual services for goods, money, or other services (Centers for Disease Control and Prevention, 2022a). FSSW report relatively poorer physical and mental health compared to others (Ramos et al., 2022; Rekart, 2005). Related, the CDC indicates that due to the nature of sex work, sex workers may be disproportionately at-risk for contracting Human Immunodeficiency Virus (HIV; Centers for Disease Control and Prevention, 2022a). However, a variety of factors may relate to HIV-risk in this population. Specifically, different multi-level factors may relate to sex workers’ willingness to use pre-exposure prophylaxis (PrEP), a once-daily HIV preventative medication (Centers for Disease Control and Prevention, 2022a). While highly effective against HIV, PrEP uptake in several key HIV populations is slow (Holloway et al., 2017). Here, I adapted the Social-Ecological Model (Kaufman et al., 2014), with the assistance of lived-experience members and community organizations in developing and disseminating the study, to assess barriers and facilitators towards PrEP uptake willingness for FSSW and investigated a distal-proximal stigma-based mediation analysis to PrEP willingness. I found that two barriers and two facilitators initially emerged as significant predictor of PrEP uptake willingness. However, in adopting a more conservative approach, only (a) anticipating stigmatizing disapproval from others, and (b) providing others with PrEP knowledge, independently remained as a significant barrier and facilitator to PrEP uptake willingness, respectfully. Mediation analysis did not yield a distal-proximal stigma-based mediation of PrEP uptake willingness. Implications for future research, clinical work, and policy are discussed. Show less
