The HIV Care Continuum among Female Sex Workers: A Key Population in Lilongwe, Malawi

被引:39
|
作者
Lancaster, Kathryn Elizabeth [1 ,3 ]
Powers, Kimberly A. [1 ]
Lungu, Thandie [2 ]
Mmodzi, Pearson [2 ]
Hosseinipour, Mina C. [2 ,3 ]
Chadwick, Katy [4 ]
Go, Vivian F. [5 ]
Pence, Brian W. [1 ]
Hoffman, Irving F. [2 ,3 ]
Miller, William C. [1 ,3 ]
机构
[1] Univ N Carolina, Dept Epidemiol, Gillings Sch Global Publ Hlth, Chapel Hill, NC USA
[2] Univ N Carolina, UNC Project Malawi, Lilongwe, Malawi
[3] Univ N Carolina, Sch Med, Div Infect Dis, Chapel Hill, NC USA
[4] Theatre Change, Lilongwe, Malawi
[5] Univ N Carolina, Gillings Sch Global Publ Hlth, Dept Hlth Behav, Chapel Hill, NC USA
来源
PLOS ONE | 2016年 / 11卷 / 01期
基金
美国国家卫生研究院;
关键词
SUB-SAHARAN AFRICA; DRIED BLOOD SPOTS; ANTIRETROVIRAL TREATMENT; RISK BEHAVIORS; RESPONDENT-DRIVEN; PREVENTION; TRANSMISSION; PREVALENCE; INFECTION; MEN;
D O I
10.1371/journal.pone.0147662
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Objective The HIV care continuum among female sex workers (FSW), a key population, has not been well characterized, especially within the generalized epidemics of sub-Saharan Africa. This was the first study to characterize the HIV care continuum among FSW in Lilongwe, Malawi. Methods From July through September 2014, we used venue-based sampling to enroll 200 adult FSW in Lilongwe, Malawi into a cross-sectional evaluation assessing HIV care continuum outcomes. Seropositive FSW, identified using HIV rapid testing, received rapid CD4 counts in addition to viral loads using dried blood spots. We calculated proportions of HIV-infected FSW who had history of care, were on ART, and had suppressed viral load and we used Poisson regression to estimate the associations of demographic characteristics and transmission risk behaviors with each outcome. Results HIV seroprevalence was 69% (n = 138). Among all FSW the median age was 24 years (IQR: 22-28). Among the 20% who were newly diagnosed and reported previously testing negative, the median time since last HIV test was 11 months (interquartile range: 3-17). The majority (69%) of HIV-infected FSW had a history of HIV care, 52% reported current ART use, and 45% were virally suppressed. Of the FSW who reported current ART use, 86% were virally suppressed. Transmission risk behaviors were not associated with continuum outcomes. Conclusions FSW in Lilongwe were predominately young and have a high HIV prevalence. Only half of HIV-infected FSW reported current ART use, but the majority of those on ART were virally suppressed. To reduce ongoing transmission and improve health outcomes, increased HIV testing, care engagement, and ART coverage is urgently needed among FSW. Universal testing and treatment strategies for all FSWin Malawi must be strongly considered.
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页数:15
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