Abstract
Key populations have disproportionately higher HIV prevalence rates than the general population. To determine the level of virologic suppression and associated factors in female Commercial Sex Workers (CSW) who completed six months of ART and compare with the female general population (GP). Clinical records of CSW and GPs who initiated ART between December 2014 to December 2016 from seven urban clinics were analyzed to determine virologic suppression (viral load < 1000 copies/ml) and associated factors. We identified 218 CSW and 182 female GPs. CSW had median age of 28 (IQR 25-31) vs 31 (IQR 26-37); median baseline CD4 446 (IQR 308-696) vs 352 (IQR 164-493) cells/microL; and optimal ART adherence levels at 70.6% vs 92.8% respectively, compared to GP. Virologic suppression in CSW and GPs was 85.7% and 89.6% respectively, P=0.28. Overall virologic suppression in CSW was 55% while Retention in care after 6 months of ART was 77.5%. Immediate ART initiation (<2weeks) and tuberculosis independently predicted virologic suppression in CSW with adjusted odds ratios 0.07 (95% C.I. 0.01-0.55, P=0.01) and 0.09 (95% C.I. 0.01-0.96, P=0.046) respectively. Virologic suppression in both groups is similar, however, intensified follow-up is needed to improve treatment outcomes.
Highlights
Key populations have disproportionately higher HIV prevalence rates than the general population
We identified 218 Commercial Sex Workers (CSW) and 182 female general population (GP)
The general population (GP) were initiated on antiretroviral therapy (ART) within 2 weeks or longer from the time of enrolment in care. Both Key Population (KP) and GP who initiated ART would be given monthly clinic appointments to monitor their adherence by pill count method
Summary
Key populations have disproportionately higher HIV prevalence rates than the general population. Objective: To determine the level of virologic suppression and associated factors in female Commercial Sex Workers (CSW) who completed six months of ART and compare with the female general population (GP). HIV positive key populations such as commercial sex workers (CSW) have disproportionately high HIV prevalence rates and contribute nearly half of the global new HIV infection rates[1,2]. ART coverage and virologic suppression in key populations remain significantly low despite the relatively high burden of HIV in these population groups. A study in Cameroon found that ART coverage in CSW was 13% compared to 56.5% for the HIV general population[11].
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