scholarly journals Effect of HIV Self-Testing on PrEP Adherence among Gender Diverse Sex Workers in Uganda

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Andrew Mujugira ◽  
Agnes Nakyanzi ◽  
Maria Sarah Nabaggala ◽  
Timothy R Muwonge ◽  
Timothy Ssebuliba ◽  
...  
Keyword(s):  
Sex Workers ◽  
Gender Diverse ◽  
Self Testing

Peer assisted HIV self-testing increases positivity rates among key populations in Burundi: descriptive analysis of routine programmatic data (Preprint)

2020 ◽  
Author(s):  
Tiffany Lillie ◽  
Dorica Boyee ◽  
Gloriose Kamariza ◽  
Alphonse Nkunzimana ◽  
Dismas Gashobotse ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Sex Workers ◽  
Descriptive Analysis ◽  
Case Finding ◽  
Hiv Positive ◽  
Key Populations ◽  
Standard Testing ◽  
Art Initiation ◽  
Treatment Standard ◽  
Self Testing

BACKGROUND In Burundi, given the low testing numbers among key populations, peer assisted HIV self-testing (HIVST) was initiated for female sex workers (FSWs), men who have sex with men (MSM), and transgender people (TG) to provide another testing option. HIVST was provided by existing peer outreach workers (POWs) who were trained to provide support before, during, and after the administration of the test. People who screened reactive were referred and actively linked to confirmatory testing, and those confirmed positive were linked to treatment. Standard testing included HIV testing by clinical staff either at mobile clinics or in facilities. OBJECTIVE The objective was to improve access to HIV testing to underserved KP members, increase HIV positivity rates, and link those who were confirmed HIV positive with life-saving treatment for epidemic control. METHODS A descriptive analysis of routine programmatic data was conducted from a nine-month implementation period (June 2018-March 2019) of peer assisted HIVST among FSWs, MSM, and TG in six provinces where the USAID- and PEPFAR-funded LINKAGES Burundi project worked. Chi-squared tests were used to compare case-finding rates among individuals tested through HIVST versus standard testing. RESULTS A total of 2,198 HIVST test kits were administered (1,791 FSWs, 363 MSM, 44 TG). Three hundred and sixty-six people (17%) were reactive to HIV screening (296 FSWs, 60 MSM, 10 TG); 314 (14%) were confirmed HIV positive (257 FSWs, 47 MSM, 10 TG); and 301 (96%) (251 FSWs, 40 MSM, 10 TG) of those confirmed were initiated on treatment. HIV case-finding rates were significantly higher with HIVST compared to standard testing for FSW and MSM but not TG: FSWs (14% vs. 9%, P < .001); MSM (13% vs. 4%, P < .001); and TG (23% vs. 17%, P > .10). ART initiation rates were significantly lower for MSM confirmed HIV positive through HIVST than through standard testing (85% vs. 99%, P < .001) but not among FSWs or TG (FSWs: 98% vs. 97%, P > .10; TG: 100% vs. 100%). CONCLUSIONS The results demonstrate the potential effectiveness of HIVST in identifying individuals who are living with HIV.

scholarly journals HIV testing and its associated factors among street-based female sex workers in Iran: results of a national rapid assessment and response survey

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Sina Ahmadi ◽  
Mehrdad Khezri ◽  
Payam Roshanfekr ◽  
Salah Eddin Karimi ◽  
Meroe Vameghi ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Sex Workers ◽  
Associated Factors ◽  
Female Sex Workers ◽  
Rapid Assessment ◽  
Evidence Based ◽  
Multivariable Model ◽  
Sexually Transmitted ◽  
Female Sex ◽  
Self Testing

Abstract Background Female sex workers (FSWs) are at a disproportionate risk of sexually transmitted infections and they may face significant barriers to HIV testing. This study aimed to examine HIV testing prevalence and its associated factors among street-based FSWs in Iran. Method A total of 898 FSWs were recruited from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Eligible FSWs were women aged 18 years of age who had at least one commercial sexual intercourse in the previous year. HIV testing was defined as having tested for HIV in the lifetime. Bivariable and multivariable logistic regression were used to examine the correlates of HIV testing. We report adjusted odds ratios (aOR) and their 95% confidence intervals (CI). Result Overall, 57.8% (95%CI: 20.0, 88.0) of participants reported having tested for HIV, and HIV prevalence among FSWs who tested for HIV was 10.3% (95%CI: 7.5, 13.0). The multivariable model showed that unstable housing (aOR: 8.86, 95%CI: 2.68, 29.32) and drug use (aOR: 3.47, 95%CI: 1.33, 9.06) were associated with increased likelihood of HIV testing. However, FSWs with a higher level of income were less likely to be tested for HIV (aOR: 0.09, 95%CI: 0.02, 0.43). Conclusion Almost one in ten street-based FSWs had never tested for HIV. These findings suggest the need for evidence-based strategies such as outreach support and HIV self-testing to improve HIV testing in this marginalized population.

HIV self-testing in Pune, India: perspectives and recommendations of female sex workers and peer educators

AIDS Care ◽  
2019 ◽  
Vol 32 (2) ◽  
pp. 182-185 ◽  
Author(s):  
Yanni M. Chang ◽  
Tejaswi Sevekari ◽  
Ann Duerr ◽  
Yamilé Molina ◽  
Trupti Gilada
Keyword(s):  
Sex Workers ◽  
Female Sex Workers ◽  
Peer Educators ◽  
Female Sex ◽  
Self Testing

scholarly journals The Effect of HIV Self-Testing Delivery Models on Female Sex Workers’ Sexual Behaviors: A Randomized Controlled Trial in Urban Uganda

2019 ◽  
Vol 23 (5) ◽  
pp. 1225-1239 ◽  
Author(s):  
Katrina F. Ortblad ◽  
Daniel Kibuuka Musoke ◽  
Thomson Ngabirano ◽  
Aidah Nakitende ◽  
Guy Harling ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Sexual Behaviors ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Female Sex ◽  
Self Testing ◽  
Delivery Models

scholarly journals Female sex workers perspectives and concerns regarding HIV self-testing: An exploratory study in Tanzania

2019 ◽  
Author(s):  
Soori Nnko ◽  
Daniel Nyato ◽  
Evodius Kuringe ◽  
Caterina Casalini ◽  
Amani Shao ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Sex Workers ◽  
Exploratory Study ◽  
Female Sex Workers ◽  
Health Care Facilities ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Female Sex ◽  
Self Testing ◽  
Study Participants

Abstract Background: HIV testing is a gateway to HIV care and treatment for those testing positive and can link those with negative results to HIV preventive services. Despite the importance of HIV testing services (HTS) in HIV control, uptake of HTS among female sex workers (FSWs) across sub-Saharan Africa (SSA) remains sub optimal. Concerns about stigma associated with sex work and fear of loss of livelihood if HIV status becomes known, are some of the restrictions for FSWs to utilize HTS offered through health care facilities. Introduction of HIV self-testing (HIVST) may mitigate some of the barriers for the uptake of HTS. This study explored perspectives of FSWs towards HIVST in Tanzania. Methods: We conducted an exploratory study employing in-depth interviews (IDI) and participatory group discussions (PGD) with FSWs in selected regions of Tanzania. Study participants were recruited through snowball sampling. Data were thematically analysed by two analysts using NVivo software. Emerging themes were explored in the tradition of Grounded Theory. The analysis was informed by the social ecological model and focused on factors associated with the feasibility of scaling up HIVST. Results: A total of 23 PGD sessions were conducted involving 227 FSWs. Data from PGDs were complemented by 21 IDI. FSWs were enthusiastic toward HIVST. Convenience (time and cost saved), and belief that HIVST will increase privacy and confidentiality motivated participants’ support for the self-testing approach. Participants did express concerns about their ability to interpret and trust the results of the test. Participants also expressed concern that HIVST could cause personal harm, including severe distress and self-harm for individuals with reactive test. This was linked to the study participants’ perception that HIVST would be provided only through unassisted modality. Conclusions: FSWs demonstrated high enthusiasm to use the HIVST once it becomes available. Increased confidentiality, reduced opportunity costs, and increased autonomy were among the key factors for the intended use of HIVST. Major concerns included fear of HIV reactive test and not trusting self-diagnoses. Our findings underscore the importance of providing adequate access to counselling and referral services in conjunction with HIVST.

scholarly journals Criminalisation, Health, and Labour Rights Among Im/migrant Sex Workers Globally

2021 ◽  
pp. 153-171
Author(s):  
Bronwyn McBride ◽  
Trachje Janushev
Keyword(s):  
Public Health ◽  
Sex Work ◽  
Sex Workers ◽  
Lived Experiences ◽  
Health Access ◽  
Structural Determinants ◽  
Labour Rights ◽  
Sti Testing ◽  
Gender Diverse ◽  
And Gender

AbstractThis chapter introduces the structural determinants that shape health and labour rights among im/migrant sex workers globally. It explores issues related to criminalisation, mandatory health testing, precarious immigration status, economic marginalisation, racialisation, racism and discrimination, language barriers, and gender. This chapter examines how these factors shape health access, health outcomes, and labour rights among im/migrant sex workers in diverse contexts. These issues were explored through a review of academic literature, which was complemented by community consultations that elucidate the lived experiences of gender-diverse im/migrant sex workers from Europe and across the globe. Findings illustrate how shifting sex work criminalisation, public health and immigration regulations (e.g. sex worker registration, mandatory HIV/STI testing), and policing practices impact im/migrant sex workers and shape the labour environments in which they work. The chapter subsequently presents recommendations on policy and programmatic approaches to enhance health access and labour rights among im/migrant sex workers. Finally, it concludes by highlighting the ways in which im/migrant sex workers resist social and structural exclusion, stigma, and ‘victim’ stereotypes, highlighting their tenacity and leadership in the fight to advance labour and human rights among im/migrants and sex workers worldwide.

scholarly journals Early observations from the HIV self-testing program among key populations and sexual partners of pregnant mothers in Kampala, Uganda: A cross sectional study

2022 ◽  
Vol 2 (1) ◽  
pp. e0000120
Author(s):  
Esther Nasuuna ◽  
Florence Namimbi ◽  
Patience A. Muwanguzi ◽  
Donna Kabatesi ◽  
Madina Apolot ◽  
...  
Keyword(s):  
Sex Workers ◽  
Linkage To Care ◽  
Sexual Partners ◽  
Phone Call ◽  
Hiv Positive ◽  
Key Populations ◽  
Cross Sectional ◽  
Confirmatory Testing ◽  
Self Testing ◽  
Positive Results

Background HIV self-testing (HIVST) was adopted for key populations (KPs) and sexual partners of pregnant and lactating women (mothers) in Uganda in October 2018. We report early observations during HIVST implementation in Kampala, Uganda. Methods HIVST was rolled out to reach those with unknown HIV status at 38 public health facilities, using peer-to-peer community-based distribution for female sex workers (FSW) and men who have sex with men (MSM) and secondary distribution for mothers, who gave HIVST kits to their partners. Self-testers were asked to report results within 2 days; those who did not report received a follow-up phone call from a trained health worker. Those with HIV-positive results were offered confirmatory testing at the facility using the standard HIV-testing algorithm. Data on kits distributed, testing yield, and linkage to care were analysed. Results We distributed 9,378 HIVST kits. Mothers received 5,212 (56%) for their sexual partners while KPs received 4,166 (44%) (MSM, 2192 [53%]; FSW1, 974, [47%]). Of all kits distributed, 252 (3%) individuals had HIV-positive results; 126 (6.5%) FSW, 52 (2.3%) MSM and 74 (1.4%) partners of mothers. Out of 252 individuals who had HIV-positive results, 170 (67%) were confirmed HIV-positive; 36 (2%) were partners of mothers, 99 (58%) were FSW, and 35 (21%) were MSM. Linkage to treatment (126) was 74%. Conclusions HIVST efficiently reached, tested, identified and modestly linked to care HIV positive FSW, MSM, and partners of mothers. However, further barriers to confirmatory testing and linkage to care for HIV-positive self-testers remain unexplored.

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