Virologic suppression and associated factors in HIV infected Ugandan female sex workers: a cross-sectional study

Afr Health Sci. 2021 Jun;21(2):603-613. doi: 10.4314/ahs.v21i2.15.

Abstract

Introduction: 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).

Methods: 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.

Results: 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.

Conclusion: Virologic suppression in both groups is similar, however, intensified follow-up is needed to improve treatment outcomes.

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active*
  • Cross-Sectional Studies
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Infections / virology*
  • Health Services Accessibility
  • Humans
  • Medication Adherence / psychology
  • Sex Workers / psychology*
  • Sex Workers / statistics & numerical data
  • Uganda / epidemiology
  • Viral Load / drug effects*