Date of Award

January 2016

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Danya Keene


Female sex workers (FSW) in Malaysia are at substantially increased risk of acquiring HIV compared to the general female population. Daily oral pre-exposure prophylaxis (PrEP) offers a novel way to prevent HIV transmission in this population. This research aims to inform culturally relevant implementation of PrEP through a qualitative exploration of the factors that determine FSW willingness to use PrEP. In-depth, semi-structured interviews (n=30) were conducted with FSW in English, Malay, or Tamil. Transcribed and translated interviews were analyzed using a grounded theory approach. FSW expressed positive interest in PrEP but preferred it as a supplement to condoms, not a replacement. Perceived challenges to PrEP use included cost, adherence, side effects, and disinterest. FSW experiences with HIV and condoms support these reactions. This research bolsters prior work on the inapplicability of behavioral disinhibition to FSW and supports PrEP implementation in combination with condom promotion.


This is an Open Access Thesis.

Open Access

This Article is Open Access