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The HIV care continuum and HIV-1 drug resistance among female sex workers : a key population in Guinea-Bissau

Lindman, Jacob LU ; Djalo, Mamadu Aliu ; Biai, Ansu ; Månsson, Fredrik LU ; Esbjörnsson, Joakim LU ; Jansson, Marianne LU ; Medstrand, Patrik LU and Norrgren, Hans LU (2020) In AIDS Research and Therapy 17(1).
Abstract

INTRODUCTION: Female sex workers (FSW) are considered a key group for HIV transmissions in sub-Saharan Africa. The HIV Care Continuum and HIV drug resistance (HIVDR) among FSW has not been well studied in most countries in West Africa. In the current study we describe the HIV Care continuum and prevalence of HIVDR among FSW in Guinea-Bissau. METHODS: A venue-based recruitment and peer-referral of FSW was used in seven cities in Guinea-Bissau from October 2014 to September 2017. We administered a questionnaire, performed discriminatory HIV-testing and collected blood specimens for CD4 count, viral load and HIVDR genotyping. RESULTS: The survey included 440 FSW. The overall HIV-prevalence among FSW was 26.8%. Of the HIV-1 (HIV-1 single-... (More)

INTRODUCTION: Female sex workers (FSW) are considered a key group for HIV transmissions in sub-Saharan Africa. The HIV Care Continuum and HIV drug resistance (HIVDR) among FSW has not been well studied in most countries in West Africa. In the current study we describe the HIV Care continuum and prevalence of HIVDR among FSW in Guinea-Bissau. METHODS: A venue-based recruitment and peer-referral of FSW was used in seven cities in Guinea-Bissau from October 2014 to September 2017. We administered a questionnaire, performed discriminatory HIV-testing and collected blood specimens for CD4 count, viral load and HIVDR genotyping. RESULTS: The survey included 440 FSW. The overall HIV-prevalence among FSW was 26.8%. Of the HIV-1 (HIV-1 single- or dually HIV-1/HIV-2) infected FSW (N = 104), 58.7% were previously diagnosed with HIV-1 at enrolment and 41.4% reported taking antiretroviral therapy (ART) compared to 28.6% of the HIV-2 single-infected FSW (N = 14). Among HIV-1 infected FSW on ART (N = 43), 55.8% were virally suppressed (< 1000 copies/ml) and of all HIV-1 infected FSW, 29.8% were virally suppressed. Among ART experienced FSW (N = 22), 50.0% had HIVDR. HIVDR was also found in 9.4% of treatment naïve FSW (N = 53). CONCLUSION: The majority of FSW who knew their HIV status received ART, however a large proportion of FSW were not aware of their HIV positive status. This translated into a great majority of the HIV-infected FSW not being virally suppressed. Amongst treatment naïve FSW nearly a tenth had HIVDR, suggesting that sexual transmission of HIVDR is occurring in this at-risk-population.

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author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Africa, Antiretroviral therapy, Drug resistance mutations, HIV care continuum, HIV seroprevalence, Sex workers
in
AIDS Research and Therapy
volume
17
issue
1
article number
33
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85086557485
  • pmid:32532294
ISSN
1742-6405
DOI
10.1186/s12981-020-00290-3
language
English
LU publication?
yes
id
f187bb71-24aa-4edd-81c7-7d883c951187
date added to LUP
2020-07-02 13:49:35
date last changed
2020-07-03 03:00:03
@article{f187bb71-24aa-4edd-81c7-7d883c951187,
  abstract     = {<p>INTRODUCTION: Female sex workers (FSW) are considered a key group for HIV transmissions in sub-Saharan Africa. The HIV Care Continuum and HIV drug resistance (HIVDR) among FSW has not been well studied in most countries in West Africa. In the current study we describe the HIV Care continuum and prevalence of HIVDR among FSW in Guinea-Bissau. METHODS: A venue-based recruitment and peer-referral of FSW was used in seven cities in Guinea-Bissau from October 2014 to September 2017. We administered a questionnaire, performed discriminatory HIV-testing and collected blood specimens for CD4 count, viral load and HIVDR genotyping. RESULTS: The survey included 440 FSW. The overall HIV-prevalence among FSW was 26.8%. Of the HIV-1 (HIV-1 single- or dually HIV-1/HIV-2) infected FSW (N = 104), 58.7% were previously diagnosed with HIV-1 at enrolment and 41.4% reported taking antiretroviral therapy (ART) compared to 28.6% of the HIV-2 single-infected FSW (N = 14). Among HIV-1 infected FSW on ART (N = 43), 55.8% were virally suppressed (&lt; 1000 copies/ml) and of all HIV-1 infected FSW, 29.8% were virally suppressed. Among ART experienced FSW (N = 22), 50.0% had HIVDR. HIVDR was also found in 9.4% of treatment naïve FSW (N = 53). CONCLUSION: The majority of FSW who knew their HIV status received ART, however a large proportion of FSW were not aware of their HIV positive status. This translated into a great majority of the HIV-infected FSW not being virally suppressed. Amongst treatment naïve FSW nearly a tenth had HIVDR, suggesting that sexual transmission of HIVDR is occurring in this at-risk-population.</p>},
  author       = {Lindman, Jacob and Djalo, Mamadu Aliu and Biai, Ansu and Månsson, Fredrik and Esbjörnsson, Joakim and Jansson, Marianne and Medstrand, Patrik and Norrgren, Hans},
  issn         = {1742-6405},
  language     = {eng},
  number       = {1},
  publisher    = {BioMed Central (BMC)},
  series       = {AIDS Research and Therapy},
  title        = {The HIV care continuum and HIV-1 drug resistance among female sex workers : a key population in Guinea-Bissau},
  url          = {http://dx.doi.org/10.1186/s12981-020-00290-3},
  doi          = {10.1186/s12981-020-00290-3},
  volume       = {17},
  year         = {2020},
}