HIV Prevalence and the HIV Treatment Cascade Among Female Sex Workers in Cross-Border Areas in East Africa

AIDS Behav. 2022 Feb;26(2):556-568. doi: 10.1007/s10461-021-03411-9. Epub 2021 Aug 11.

Abstract

In cross-border areas of East Africa, sexual networks include partnerships across resident, migrant, and mobile populations, and risky behaviors can coincide with fragmented health services given the challenges of cross-border coordination. Among those most at risk are female sex workers (FSWs). We map HIV prevalence among FSWs in 14 cross-border areas, estimate associations between FSW characteristics and HIV and undiagnosed HIV, and estimate progress towards the UNAIDS 90-90-90 targets. The 2016-2017 East Africa Cross-Border Integrated Health Study recruited 4040 women; 786 were classified as FSWs. Overall HIV prevalence among FSWs was 10.8% (95% CI 8.2%, 13.3%), though area-specific estimates varied considerably. Among FSWs living with HIV, 46.1% (95% CI 33.2%, 59.0%) knew their status, 80.6% (95% CI 66.3%, 94.9%) of FSWs who knew their status were on ART, and 84.8% (95% CI 66.1%, 100.0%) of FSWs on ART were virally suppressed. Results indicate a need for expanded HIV testing.

Keywords: Africa; Eastern; Emigration and immigration; HIV-1; Sex workers; Viral load.

MeSH terms

  • Cross-Sectional Studies
  • Female
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • Humans
  • Prevalence
  • Sex Workers*
  • Sexual Behavior