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The HIV Care Continuum among Female Sex Workers: A Key Population in Lilongwe, Malawi.

Publication ,  Journal Article
Lancaster, KE; Powers, KA; Lungu, T; Mmodzi, P; Hosseinipour, MC; Chadwick, K; Go, VF; Pence, BW; Hoffman, IF; Miller, WC
Published in: PLoS One
2016

OBJECTIVE: The HIV care continuum among female sex workers (FSW), a key population, has not been well characterized, especially within the generalized epidemics of sub-Saharan Africa. This was the first study to characterize the HIV care continuum among FSW in Lilongwe, Malawi. METHODS: From July through September 2014, we used venue-based sampling to enroll 200 adult FSW in Lilongwe, Malawi into a cross-sectional evaluation assessing HIV care continuum outcomes. Seropositive FSW, identified using HIV rapid testing, received rapid CD4 counts in addition to viral loads using dried blood spots. We calculated proportions of HIV-infected FSW who had history of care, were on ART, and had suppressed viral load and we used Poisson regression to estimate the associations of demographic characteristics and transmission risk behaviors with each outcome. RESULTS: HIV seroprevalence was 69% (n = 138). Among all FSW the median age was 24 years (IQR: 22-28). Among the 20% who were newly diagnosed and reported previously testing negative, the median time since last HIV test was 11 months (interquartile range: 3-17). The majority (69%) of HIV-infected FSW had a history of HIV care, 52% reported current ART use, and 45% were virally suppressed. Of the FSW who reported current ART use, 86% were virally suppressed. Transmission risk behaviors were not associated with continuum outcomes. CONCLUSIONS: FSW in Lilongwe were predominately young and have a high HIV prevalence. Only half of HIV-infected FSW reported current ART use, but the majority of those on ART were virally suppressed. To reduce ongoing transmission and improve health outcomes, increased HIV testing, care engagement, and ART coverage is urgently needed among FSW. Universal testing and treatment strategies for all FSW in Malawi must be strongly considered.

Duke Scholars

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Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2016

Volume

11

Issue

1

Start / End Page

e0147662

Location

United States

Related Subject Headings

  • Young Adult
  • Viral Load
  • Sex Work
  • Malawi
  • Humans
  • HIV Infections
  • General Science & Technology
  • Female
  • Continuity of Patient Care
  • Anti-HIV Agents
 

Citation

APA
Chicago
ICMJE
MLA
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Lancaster, K. E., Powers, K. A., Lungu, T., Mmodzi, P., Hosseinipour, M. C., Chadwick, K., … Miller, W. C. (2016). The HIV Care Continuum among Female Sex Workers: A Key Population in Lilongwe, Malawi. PLoS One, 11(1), e0147662. https://doi.org/10.1371/journal.pone.0147662
Lancaster, Kathryn Elizabeth, Kimberly A. Powers, Thandie Lungu, Pearson Mmodzi, Mina C. Hosseinipour, Katy Chadwick, Vivian F. Go, Brian W. Pence, Irving F. Hoffman, and William C. Miller. “The HIV Care Continuum among Female Sex Workers: A Key Population in Lilongwe, Malawi.PLoS One 11, no. 1 (2016): e0147662. https://doi.org/10.1371/journal.pone.0147662.
Lancaster KE, Powers KA, Lungu T, Mmodzi P, Hosseinipour MC, Chadwick K, et al. The HIV Care Continuum among Female Sex Workers: A Key Population in Lilongwe, Malawi. PLoS One. 2016;11(1):e0147662.
Lancaster, Kathryn Elizabeth, et al. “The HIV Care Continuum among Female Sex Workers: A Key Population in Lilongwe, Malawi.PLoS One, vol. 11, no. 1, 2016, p. e0147662. Pubmed, doi:10.1371/journal.pone.0147662.
Lancaster KE, Powers KA, Lungu T, Mmodzi P, Hosseinipour MC, Chadwick K, Go VF, Pence BW, Hoffman IF, Miller WC. The HIV Care Continuum among Female Sex Workers: A Key Population in Lilongwe, Malawi. PLoS One. 2016;11(1):e0147662.

Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2016

Volume

11

Issue

1

Start / End Page

e0147662

Location

United States

Related Subject Headings

  • Young Adult
  • Viral Load
  • Sex Work
  • Malawi
  • Humans
  • HIV Infections
  • General Science & Technology
  • Female
  • Continuity of Patient Care
  • Anti-HIV Agents