Integrating HIV Into Sexual and Reproductive Health Services for Female Sex Workers in Buenos Aires, Argentina: A Comprehensive Model Designed Through Intersectional Collaboration

INTRODUCTION: Female sex workers (FSWs) are at higher risk of sexually transmitted infections (STIs), including HIV, due to occupation-related factors further exacerbated by gender-specific vulnerability and marginalization. Stigma and fear of disclosing their occupation pose multiple barriers that limit access to sexual and reproductive health (SRH) services, as well as HIV testing, prevention and treatment. We describe the implementation of a tailored comprehensive SRH-HIV prevention and care model for FSWs, and report HIV prevalence, pre-exposure prophylaxis (PrEP) uptake and HIV treatment outcomes in our cohort. METHODS: "MAS por Nosotras" adopted a co-creation and co-production approach including a formative phase (focus groups with FSWs and semistructured interviews with stakeholders), and a prospective cohort of FSWs at a non-governmental organization (NGO) in Argentina. Our conceived model focused on HIV treatment and combination prevention, including STI testing, cancer screening, contraception counselling and vaccination. Demographic, psychosocial and clinical information were collected. RESULTS: Between June 2023 and March 2024, 200 cisgender and transgender FSWs were enrolled in the prospective cohort, with a 66.5% retention rate at 6 months. HIV prevalence was 18.5% (34.3% in transgender women [TGW] and 3% in cisgender women [CGW]), with only one incident case during follow-up. Among those with known HIV, 61% had a viral load