The HIV Care Cascade among Female Sex Workers in Zimbabwe: Results of a Population-Based Survey From the Sisters Antiretroviral Therapy Programme for Prevention of HIV, an Integrated Response (SAPPH-IRe) Trial

April 2017 - Epidemiology

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Cowan, F.M., Davey, C.B., Fearon, E., et al. Journal of Acquired Immune Deficiency Syndromes (April 2017), 74(4):375-382, doi:10.1097/QAI.0000000000001255.

The authors of this study conducted cross-sectional respondent-driven sampling (RDS) surveys of female sex workers (FSWs) in 14 sites across Zimbabwe as the baseline for the SAPPH-IRe cluster-randomized, controlled trial (2013–2016), which investigated a combination HIV prevention and care package for this population. They recruited 2,722 women aged 18–65 years (approximately 200 per site), administered a questionnaire, tested the women for HIV, and measured viral load. The mean HIV prevalence was 57.5 percent. Of HIV-positive women, 64.0 percent knew their status. Among women with known status, 67.7 percent reported taking antiretroviral therapy (ART); and 77.8 percent of FSWs on ART had a suppressed HIV viral load (<1,000 copies/mL). Among all HIV-positive women, 49.5 percent had a viral load <1,000 copies/mL. A substantial proportion of women had experienced violence (40.3% from partners, 27.7% from clients, and 9.7% from police). These findings, the authors said, pointed to an urgent need to invest in testing, care, and treatment programs to address the high HIV prevalence among FSWs in Africa.

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