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Engagement in HIV services over time among young women who sell sex in Zimbabwe

INTRODUCTION: Young female sex workers (FSW) are disproportionately vulnerable to HIV. Zimbabwe data show higher HIV incidence and lower engagement in services compared to older FSW. Utilizing data from a combination HIV prevention and treatment intervention, we describe engagement in the HIV servic...

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Autores principales: Napierala, Sue, Chabata, Sungai T., Davey, Calum, Fearon, Elizabeth, Busza, Joanna, Mushati, Phillis, Mugurungi, Owen, Hatzold, Karin, Cambiano, Valentina, Phillips, Andrew, Hargreaves, James R., Cowan, Frances M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9239457/
https://www.ncbi.nlm.nih.gov/pubmed/35763532
http://dx.doi.org/10.1371/journal.pone.0270298
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author Napierala, Sue
Chabata, Sungai T.
Davey, Calum
Fearon, Elizabeth
Busza, Joanna
Mushati, Phillis
Mugurungi, Owen
Hatzold, Karin
Cambiano, Valentina
Phillips, Andrew
Hargreaves, James R.
Cowan, Frances M.
author_facet Napierala, Sue
Chabata, Sungai T.
Davey, Calum
Fearon, Elizabeth
Busza, Joanna
Mushati, Phillis
Mugurungi, Owen
Hatzold, Karin
Cambiano, Valentina
Phillips, Andrew
Hargreaves, James R.
Cowan, Frances M.
author_sort Napierala, Sue
collection PubMed
description INTRODUCTION: Young female sex workers (FSW) are disproportionately vulnerable to HIV. Zimbabwe data show higher HIV incidence and lower engagement in services compared to older FSW. Utilizing data from a combination HIV prevention and treatment intervention, we describe engagement in the HIV services over time among FSW 18–24 years, compared to those ≥25 years of age. MATERIALS AND METHODS: Data were collected via respondent-driven sampling (RDS) surveys in 14 communities in 2013 and 2016, with >2500 FSW per survey. They included blood samples for HIV and viral load testing. As the intervention had no significant impact on HIV care cascade outcomes, data were aggregated across study arms. Analyses used RDS-II estimation. RESULTS: Mean age in 2013 and 2016 was 31 and 33 years, with 27% and 17% aged 18–24 years. Overall HIV prevalence was 59% at each timepoint, and 35% and 36% among younger FSW. From 2013 to 2016 there was an increase in young HIV-positive FSW knowing their status (38% vs 60%, OR = 2.51, p<0.01). Outcomes for all FSW improved significantly over time at all steps of the cascade, and the relative change over time was similar among older versus younger FSW for most cascade variables. DISCUSSION: Young FSW had improvements in care cascade outcomes, and proportionate improvements similar to older FSW, yet they remain less engaged in services overall. This implies that the dedicated FSW services in Zimbabwe are having a comparably positive impact across age groups, however more is likely required to address young FSW’s unique vulnerabilities and needs.
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spelling pubmed-92394572022-06-29 Engagement in HIV services over time among young women who sell sex in Zimbabwe Napierala, Sue Chabata, Sungai T. Davey, Calum Fearon, Elizabeth Busza, Joanna Mushati, Phillis Mugurungi, Owen Hatzold, Karin Cambiano, Valentina Phillips, Andrew Hargreaves, James R. Cowan, Frances M. PLoS One Research Article INTRODUCTION: Young female sex workers (FSW) are disproportionately vulnerable to HIV. Zimbabwe data show higher HIV incidence and lower engagement in services compared to older FSW. Utilizing data from a combination HIV prevention and treatment intervention, we describe engagement in the HIV services over time among FSW 18–24 years, compared to those ≥25 years of age. MATERIALS AND METHODS: Data were collected via respondent-driven sampling (RDS) surveys in 14 communities in 2013 and 2016, with >2500 FSW per survey. They included blood samples for HIV and viral load testing. As the intervention had no significant impact on HIV care cascade outcomes, data were aggregated across study arms. Analyses used RDS-II estimation. RESULTS: Mean age in 2013 and 2016 was 31 and 33 years, with 27% and 17% aged 18–24 years. Overall HIV prevalence was 59% at each timepoint, and 35% and 36% among younger FSW. From 2013 to 2016 there was an increase in young HIV-positive FSW knowing their status (38% vs 60%, OR = 2.51, p<0.01). Outcomes for all FSW improved significantly over time at all steps of the cascade, and the relative change over time was similar among older versus younger FSW for most cascade variables. DISCUSSION: Young FSW had improvements in care cascade outcomes, and proportionate improvements similar to older FSW, yet they remain less engaged in services overall. This implies that the dedicated FSW services in Zimbabwe are having a comparably positive impact across age groups, however more is likely required to address young FSW’s unique vulnerabilities and needs. Public Library of Science 2022-06-28 /pmc/articles/PMC9239457/ /pubmed/35763532 http://dx.doi.org/10.1371/journal.pone.0270298 Text en © 2022 Napierala et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Napierala, Sue
Chabata, Sungai T.
Davey, Calum
Fearon, Elizabeth
Busza, Joanna
Mushati, Phillis
Mugurungi, Owen
Hatzold, Karin
Cambiano, Valentina
Phillips, Andrew
Hargreaves, James R.
Cowan, Frances M.
Engagement in HIV services over time among young women who sell sex in Zimbabwe
title Engagement in HIV services over time among young women who sell sex in Zimbabwe
title_full Engagement in HIV services over time among young women who sell sex in Zimbabwe
title_fullStr Engagement in HIV services over time among young women who sell sex in Zimbabwe
title_full_unstemmed Engagement in HIV services over time among young women who sell sex in Zimbabwe
title_short Engagement in HIV services over time among young women who sell sex in Zimbabwe
title_sort engagement in hiv services over time among young women who sell sex in zimbabwe
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9239457/
https://www.ncbi.nlm.nih.gov/pubmed/35763532
http://dx.doi.org/10.1371/journal.pone.0270298
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