HIV treatment response among female sex workers participating in a treatment as prevention demonstration project in Cotonou, Benin

ObjectiveGlobally, HIV disproportionately affects female sex workers (FSWs) yet HIV treatment coverage is suboptimal. To improve uptake of HIV services by FSWs, it is important to identify potential inequalities in access and use of care and their determinants. Our aim is to investigate HIV treatment cascades for FSWs and non-sex workers (NSWs) in Manicaland province, Zimbabwe, and to examine the socio-demographic characteristics and intermediate determinants that might explain differences in service uptake.MethodsData from a household survey conducted in 2009–2011 and a parallel snowball sample survey of FSWs were matched using probability methods to reduce under-reporting of FSWs. HIV treatment cascades were constructed and compared for FSWs (n=174) and NSWs (n=2555). Determinants of service uptake were identified a priori in a theoretical framework and tested using logistic regression.ResultsHIV prevalence was higher in FSWs than in NSWs (52.6% vs 19.8%; age-adjusted OR (AOR) 4.0; 95% CI 2.9 to 5.5). In HIV-positive women, FSWs were more likely to have been diagnosed (58.2% vs 42.6%; AOR 1.62; 1.02–2.59) and HIV-diagnosed FSWs were more likely to initiate ART (84.9% vs 64.0%; AOR 2.33; 1.03–5.28). No difference was found for antiretroviral treatment (ART) adherence (91.1% vs 90.5%; P=0.9). FSWs’ greater uptake of HIV treatment services became non-significant after adjusting for intermediate factors including HIV knowledge and risk perception, travel time to services, physical and mental health, and recent pregnancy.ConclusionFSWs are more likely to take up testing and treatment services and were closer to achieving optimal outcomes along the cascade compared with NSWs. However, ART coverage was low in all women at the time of the survey. FSWs’ need for, knowledge of and proximity to HIV testing and treatment facilities appear to increase uptake.

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HIV Testing and Engagement in Care among Highly Vulnerable Female Sex Workers: Implications for Treatment as Prevention Models

Journal of Health Care for the Poor and Underserved ◽

10.1353/hpu.2014.0113 ◽

2014 ◽

Vol 25 (3) ◽

pp. 1360-1378 ◽

Cited By ~ 9

Author(s):

Hilary L. Surratt ◽

Catherine L. O’Grady ◽

Steven P. Kurtz ◽

Mance E. Buttram ◽

Maria A. Levi-Minzi

Keyword(s):

Hiv Testing ◽

Sex Workers ◽

Female Sex Workers ◽

Treatment As Prevention ◽

Engagement In Care ◽

Female Sex

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A Qualitative Exploration of Family, Work, Community, and Health Service Influences on HIV Treatment Uptake and Adherence Among Female Sex Workers in Three Cities in Indonesia

AIDS Education and Prevention ◽

10.1521/aeap.2020.32.3.243 ◽

2020 ◽

Vol 32 (3) ◽

pp. 243-259

Author(s):

Elke Mitchell ◽

Elan Lazuardi ◽

Irma Anintya ◽

Emily Rowe ◽

Kate Whitford ◽

...

Keyword(s):

Support Groups ◽

Sex Workers ◽

Female Sex Workers ◽

Treatment Initiation ◽

Geographical Location ◽

Hiv Treatment ◽

Hiv Care ◽

Community Based ◽

Female Sex ◽

Outreach Workers

Qualitative data were collected from 34 Indonesian female sex workers to understand their engagement with HIV treatment. Influences that enhanced treatment initiation and adherence included women's desires to stay healthy to continue working to provide for families; awareness of the biomedical benefits of treatment; support from bosses, outreach workers, and peer support groups; and flexible, nonjudgmental HIV service provision. Influences inhibiting treatment initiation and adherence included concerns about unwanted disclosure in the workplace and side effects of medication on women's capacity to earn money through sex work; geographical location of services; discrimination and confidentiality concerns in HIV care services. To improve HIV treatment initiation and adherence among Indonesian female sex workers, future responses should explore health promotion messages that engage with women's family and livelihood obligations; increased funding for community-based peer outreach workers; community-based treatment initiation and supply; and advocacy in work environments to secure support for treatment initiatives.

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Designing PrEP and early HIV treatment interventions for implementation among female sex workers in South Africa: developing and learning from a formative research process

BMJ Open ◽

10.1136/bmjopen-2017-019292 ◽

2018 ◽

Vol 8 (6) ◽

pp. e019292 ◽

Cited By ~ 6

Author(s):

Robyn Eakle ◽

Nyaradzo Mutanha ◽

Judie Mbogua ◽

Maria Sibanyoni ◽

Adam Bourne ◽

...

Keyword(s):

South Africa ◽

Sex Workers ◽

Female Sex Workers ◽

Research Process ◽

Formative Research ◽

Hiv Treatment ◽

Treatment Interventions ◽

Female Sex

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Exploring peer navigation and support in the quality of HIV care experiences of female sex workers in the Dominican Republic

BMC Health Services Research ◽

10.1186/s12913-021-07439-4 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Tahilin Sanchez Karver ◽

Clare Barrington ◽

Yeycy Donastorg ◽

Martha Perez ◽

Hoisex Gomez ◽

...

Keyword(s):

Dominican Republic ◽

Sex Workers ◽

Female Sex Workers ◽

Hiv Treatment ◽

Hiv Care ◽

Care Providers ◽

Female Sex ◽

Care Services ◽

Peer Navigation

Abstract Background Despite evidence on peer navigation’s association with positive HIV outcomes, such as engagement in HIV care and antiretroviral therapy (ART) initiation, the mechanisms through which peer navigation may influence these outcomes have been less explored. The purpose of this study is to describe the role of peer navigation and support on enhancing the quality of HIV treatment and care services experienced by female sex workers (FSWs). Methods Survey data was derived from a quantitative cohort (n = 211) of FSWs living with HIV in the Dominican Republic and complemented with data from two rounds of in-depth interviews (IDIs) from a qualitative subsample (n = 20 per round). Descriptive statistics and multivariable logistic regressions were used to explore the association between peer navigation and relational aspects of care and overall satisfaction of the quality of HIV treatment and care. Thematic analysis was employed to code and synthesize textual data from IDIs. Results 41.2% of the participants reported having had contact with a peer navigator in the last 6 months. Qualitative data revealed that peer navigation and support was instrumental in assisting FSWs linkage to HIV care after diagnosis, elevating FSWs’ ability to access more comprehensive clinical care facilities, and promoting agency by improving FSWs’ skills to more strategically and effectively engage with the clinic environment and health care providers. Peer navigation was positively associated with experiencing more respectful treatment by clinic staff (AOR: 6.65, 95% CI: 2.32–19.02), and greater satisfaction with overall HIV care services (AOR: 2.57, 95% CI: 1.77–3.74). Conclusion Promoting the full integration of peer navigation into healthcare structures is a strategic approach to enhance the quality of HIV care experienced by FSWs and improve their HIV-related outcomes.

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The association between substance use and sub-optimal HIV treatment engagement among HIV-infected female sex workers in Lilongwe, Malawi

AIDS Care ◽

10.1080/09540121.2016.1211244 ◽

2016 ◽

Vol 29 (2) ◽

pp. 197-203 ◽

Cited By ~ 14

Author(s):

Kathryn E. Lancaster ◽

Thandie Lungu ◽

Pearson Mmodzi ◽

Mina C. Hosseinipour ◽

Katy Chadwick ◽

...

Keyword(s):

Substance Use ◽

Sex Workers ◽

Female Sex Workers ◽

Treatment Engagement ◽

Hiv Treatment ◽

Infected Female ◽

Female Sex

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Uptake, retention, and outcomes in a demonstration project of pre-exposure prophylaxis among female sex workers in public health centers in Senegal

International Journal of STD & AIDS ◽

10.1177/0956462420943704 ◽

2020 ◽

Vol 31 (11) ◽

pp. 1063-1072

Author(s):

Moussa Sarr ◽

Daouda Gueye ◽

Aminata Mboup ◽

Ousmane Diouf ◽

Mame D Bousso Bao ◽

...

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

Retention In Care ◽

Older Age ◽

Demonstration Project ◽

Retention Rates ◽

Open Label ◽

Female Sex ◽

Exposure Prophylaxis

The Senegal pre-exposure prophylaxis (PrEP) Demonstration Project was an open-label cohort study assessing the delivery of daily oral PrEP to HIV-negative female sex workers (FSWs) in four Ministry of Health (MoH)-run clinics in Dakar, Senegal. We assessed uptake, retention in care, and adherence over up to 12 months of follow-up as well as HIV infection rates. Between July and November 2015, 350 individuals were approached and 324 (92.6%) were preliminarily eligible. Uptake was high, with 82.4% of eligible participants choosing to enroll and take PrEP. The mean age of those enrolled was 37.7 years (SD = 8.7), and approximately half had not attended school (41.2%). Among the 267 participants who were prescribed PrEP, 79.9 and 73.4% were retained in PrEP care at 6 and 12 months, respectively. Older age among FSWs was found to be the only significant predictor of lower discontinuation. We did not find significant differences in retention by site, education, condom use, or HIV risk perception. There were no new HIV infections at follow-up. Our results showed evidence of high interest in PrEP and very good PrEP retention rates among FSWs at 12-month follow-up when offered in MoH-run clinics, with older age as the only significant predictor of higher PrEP retention. This highlights the role that these clinics can play in expanding PrEP access nationwide.

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