Project Shikamana: Baseline Findings From a Community Empowerment-Based Combination HIV Prevention Trial among Female Sex Workers in Iringa, Tanzania

January 2017 - Combination Prevention

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Kerrigan, D., Mbwambo, J., Likindikoki, S., et al. Journal of Acquired Immune Deficiency Syndromes (January 2017), 74(Suppl 1): S60–S68. doi:10.1097/QAI.0000000000001203.

The authors presented baseline results from this study that will examine the effectiveness of an HIV prevention empowerment approach among 496 HIV-positive and -negative female sex workers (FSWs) in Tanzania. The approach includes peer education; condom distribution; HIV testing services (HTS) in entertainment venues; peer assistance for linkages and retention; clinician sensitivity training; text messaging to increase HIV knowledge and adherence; and community drop-in centers to foster social cohesion and confront stigma and discrimination, violence, and financial challenges. At baseline 48.6 percent of the participants experienced FSW-associated stigma; 50.8 percent experienced physical or sexual gender-based violence; and 49.2 percent reported drinking alcohol four or more days per week. Fewer than half of FSWs reported condom use; condoms were most often used with new clients. Nearly 48 percent reported receiving HTS within the past six months; 40.9 percent tested positive, and of these, 30.5 percent previously knew they were HIV-positive. Nearly 79 percent reported antiretroviral therapy (ART) use, and 48.4 percent experienced viral suppression, which was associated with being older, making less money, having few customers, being self-employed, and experiencing higher social cohesion with other FSWs. Significant gaps in HTS, ART adherence, and viral suppression indicated access challenges. These findings will inform implementation of the HIV prevention empowerment approach.

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