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High Level of HIV Drug Resistance and Virologic Nonsuppression among Female Sex Workers in Ethiopia : A Nationwide Cross-Sectional Study

Arimide, Dawit Assefa LU orcid ; Amogne, Minilik Demissie LU orcid ; Kebede, Yenew ; Balcha, Taye T. LU ; Adugna, Fekadu ; Ramos, Artur ; Devos, Joshua ; Zeh, Clement ; Agardh, Anette LU orcid and Chih-Wei Chang, Joy , et al. (2022) In Journal of Acquired Immune Deficiency Syndromes 89(5). p.566-574
Abstract

Objective:To determine viral load (VL) nonsuppression (VLN) rates, HIV drug resistance (HIVDR) prevalence, and associated factors among female sex workers (FSWs) in Ethiopia.Methods:A cross-sectional biobehavioral survey was conducted among FSWs in 11 cities in Ethiopia in 2014. Whole blood was collected, and HIVDR genotyping was performed. Logistic regression analysis was performed to identify factors associated with VLN and HIVDR.Results:Among 4900 participants, 1172 (23.9%) were HIV-positive and 1154 (98.5%) had a VL result. Participants were categorized into antiretroviral therapy (ART) (n = 239) and ART-naive (n = 915) groups based on self-report. From the 521 specimens (ART, 59; ART-naive, 462) with VL ≥1000 copies/mL, genotyping... (More)

Objective:To determine viral load (VL) nonsuppression (VLN) rates, HIV drug resistance (HIVDR) prevalence, and associated factors among female sex workers (FSWs) in Ethiopia.Methods:A cross-sectional biobehavioral survey was conducted among FSWs in 11 cities in Ethiopia in 2014. Whole blood was collected, and HIVDR genotyping was performed. Logistic regression analysis was performed to identify factors associated with VLN and HIVDR.Results:Among 4900 participants, 1172 (23.9%) were HIV-positive and 1154 (98.5%) had a VL result. Participants were categorized into antiretroviral therapy (ART) (n = 239) and ART-naive (n = 915) groups based on self-report. From the 521 specimens (ART, 59; ART-naive, 462) with VL ≥1000 copies/mL, genotyping was successful for 420 (80.6%) and 92 (21.9%) had drug resistance mutations (DRMs). Pretreatment drug resistance (PDR) was detected in 16.5% (63/381) of the ART-naive participants. Nucleoside reverse transcriptase inhibitor (NRTI), non-NRTIs (NNRTIs), and dual-class DRMs were detected in 40 (10.5%), 55 (14.4%), and 35 (9.2%) of the participants, respectively. Among 239 participants on ART, 59 (24.7%) had VLN. Genotyping was successfully performed for 39 (66.1%). DRMs were detected in 29 (74.4%). All 29 had NNRTI, 23 (79.3%) had NRTI or dual-class DRMs. VLN was associated with age 35 years or older, CD4+T-cell count <350 cells/mm3, and being forced into selling sex. PDR and acquired drug resistance were associated with CD4+T-cell count <350 cells/mm3(P < 0.001).Conclusions:The high VLN and HIVDR rates among FSWs underscore the need for targeted interventions to improve ART access and virologic monitoring to maximize the benefit of ART and limit the spread of HIV and HIVDR.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
acquired drug resistance, Ethiopia, female sex worker, HIV drug resistance, pretreatment drug resistance, virologic failure
in
Journal of Acquired Immune Deficiency Syndromes
volume
89
issue
5
pages
566 - 574
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:85130549828
  • pmid:34966147
ISSN
1525-4135
DOI
10.1097/QAI.0000000000002908
project
The HIV epidemic in Ethiopia – dynamics of viral transmissions and prevalence of transmitted drug resistance
The HIV-1 epidemic in Ethiopia – transmission patterns, antiretroviral drug resistance and treatment outcomes
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2022 Lippincott Williams and Wilkins. All rights reserved.
id
9f53f16c-11aa-4b73-8e86-832ef5b649bb
date added to LUP
2022-06-09 22:27:10
date last changed
2024-06-13 17:17:11
@article{9f53f16c-11aa-4b73-8e86-832ef5b649bb,
  abstract     = {{<p>Objective:To determine viral load (VL) nonsuppression (VLN) rates, HIV drug resistance (HIVDR) prevalence, and associated factors among female sex workers (FSWs) in Ethiopia.Methods:A cross-sectional biobehavioral survey was conducted among FSWs in 11 cities in Ethiopia in 2014. Whole blood was collected, and HIVDR genotyping was performed. Logistic regression analysis was performed to identify factors associated with VLN and HIVDR.Results:Among 4900 participants, 1172 (23.9%) were HIV-positive and 1154 (98.5%) had a VL result. Participants were categorized into antiretroviral therapy (ART) (n = 239) and ART-naive (n = 915) groups based on self-report. From the 521 specimens (ART, 59; ART-naive, 462) with VL ≥1000 copies/mL, genotyping was successful for 420 (80.6%) and 92 (21.9%) had drug resistance mutations (DRMs). Pretreatment drug resistance (PDR) was detected in 16.5% (63/381) of the ART-naive participants. Nucleoside reverse transcriptase inhibitor (NRTI), non-NRTIs (NNRTIs), and dual-class DRMs were detected in 40 (10.5%), 55 (14.4%), and 35 (9.2%) of the participants, respectively. Among 239 participants on ART, 59 (24.7%) had VLN. Genotyping was successfully performed for 39 (66.1%). DRMs were detected in 29 (74.4%). All 29 had NNRTI, 23 (79.3%) had NRTI or dual-class DRMs. VLN was associated with age 35 years or older, CD4<sup>+</sup>T-cell count &lt;350 cells/mm<sup>3</sup>, and being forced into selling sex. PDR and acquired drug resistance were associated with CD4<sup>+</sup>T-cell count &lt;350 cells/mm<sup>3</sup>(P &lt; 0.001).Conclusions:The high VLN and HIVDR rates among FSWs underscore the need for targeted interventions to improve ART access and virologic monitoring to maximize the benefit of ART and limit the spread of HIV and HIVDR.</p>}},
  author       = {{Arimide, Dawit Assefa and Amogne, Minilik Demissie and Kebede, Yenew and Balcha, Taye T. and Adugna, Fekadu and Ramos, Artur and Devos, Joshua and Zeh, Clement and Agardh, Anette and Chih-Wei Chang, Joy and Björkman, Per and Medstrand, Patrik}},
  issn         = {{1525-4135}},
  keywords     = {{acquired drug resistance; Ethiopia; female sex worker; HIV drug resistance; pretreatment drug resistance; virologic failure}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{566--574}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Journal of Acquired Immune Deficiency Syndromes}},
  title        = {{High Level of HIV Drug Resistance and Virologic Nonsuppression among Female Sex Workers in Ethiopia : A Nationwide Cross-Sectional Study}},
  url          = {{http://dx.doi.org/10.1097/QAI.0000000000002908}},
  doi          = {{10.1097/QAI.0000000000002908}},
  volume       = {{89}},
  year         = {{2022}},
}