High Burden of Previously Undiagnosed HIV Infections and Gaps in HIV Care Cascade for Conflict-Affected Female Sex Workers in Northern Uganda

Peer reviewed: 
Yes, item is peer reviewed.
Scholarly level: 
Faculty/Staff
Final version published as: 

Goldenberg, S. M., Muzaaya, G., Akello, M., Braschel, M., Birungi, J., & Shannon, K. (2019). High burden of previously undiagnosed HIV infections and gaps in HIV care cascade for conflict-affected female sex workers in northern Uganda. International Journal of STD & AIDS, 30(3), 275–283. https://doi.org/10.1177/0956462418804658.

Date created: 
2018-11-11
Identifier: 
DOI: 10.1177/0956462418804658
Keywords: 
Sex workers
Antiretroviral therapy
HIV diagnosis
Women living with HIV
Key populations
Abstract: 

Given the disproportionate HIV burden faced by female sex workers FSWs and limited data regarding their engagement in the HIV cascade of care in conflict-affected settings, we characterized the cascade of care and examined associations with new HIV diagnoses and antiretroviral therapy (ART) use in a community-based cohort of FSWs in conflict-affected Northern Uganda. Data were collected via FSW/peer-led time-location sampling and outreach, interview-administered questionnaires, and voluntary HIV testing. Of 400 FSWs, 33.5% were living with HIV, of whom 33.6% were new/previously undiagnosed infections and 32.8% were on ART. Unstable housing and heavy alcohol/drug use were independently associated with increased odds of new HIV diagnoses, whereas exposure to condom demonstrations and number of lifetime pregnancies were negatively associated. In subanalysis among known HIV-positive women, age and time since diagnosis were associated with ART use, whereas sexually transmitted infections were negatively associated. Findings suggest the need for FSW-tailored, peer-based, and integrated HIV and sexual and reproductive health programs to address gaps in HIV testing and treatment for FSWs in conflict-affected communities.

Language: 
English
Document type: 
Article
Rights: 
Rights remain with the authors.
File(s): 
Sponsor(s): 
Canadian Institutes of Health Research (CIHR)
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