HIV-1-specific IgA is present in the genital tract of most HIV-1-resistant Kenyan sex workers, and of a minority of lower risk uninfected women, where it is associated with risk-taking behaviour. These data suggest a role for mucosal HIV-1-specific IgA responses in HIV-1 resistance, independent of host cellular responses.
HIV prevalence and incidence were extremely high in Nairobi MSM SW; a combination of interventions including increasing condom use, pre-exposure prophylaxis and access to effective treatment is urgently needed to decrease HIV transmission in this key population.
With two million new HIV infections annually, ongoing investigations of risk factors for HIV acquisition is critical to guide ongoing HIV prevention efforts. We conducted a prospective cohort analysis of HIV uninfected female sex workers enrolled at an HIV prevention clinic in Nairobi (n = 1640). In the initially HIV uninfected cohort (70 %), we observed 34 HIV infections during 1514 person-years of follow-up, i.e. an annual incidence of 2.2 % (95 % CI 1.6-3.1 %). In multivariable Cox Proportional Hazard analysis, HIV acquisition was associated with a shorter baseline duration of sex work (aHR 0.76, 95 % CI 0.63-0.91), minimum charge/sex act (aHR 2.74, 0.82-9.15, for low vs. intermediate; aHR 5.70, 1.96-16.59, for high vs. intermediate), N. gonorrhoeae infection (aAHR 5.89, 95 % CI 2.03-17.08), sex with casual clients during menses (aHR 6.19, 95 % CI 2.58-14.84), Depo Provera use (aHR 5.12, 95 % CI 1.98-13.22), and estimated number of annual unprotected regular partner contacts (aHR 1.004, 95 % CI 1.001-1.006). Risk profiling based on baseline predictors suggested that substantial heterogeneity in HIV risk is evident, even within a key population. These data highlight several risk factors for HIV acquisition that could help to re-focus HIV prevention messages.
Objectives: To examine characteristics of pregnant women associated with cervical infection, and to evaluate the accuracy of symptom-based and risk assessment systems which have been developed for identifying cervical infection in antenatal women. Methods: Interviews were conducted and physical examinations performed on 291 consecutive antenatal clinic attenders in Nairobi, Kenya. Vaginal, cervical, urine and blood specimens were also obtained for analysis.Results: The following disease prevalences were observed: candidiasis 26-2%; trichomoniasis 19-9%; bacterial vaginosis 206%; any vaginal infection 53.8%; chlamydial cervicitis (CT) 8.8%; gonococcal cervicitis (GC) 2.4%; any cervical infection 10O8%. The only statistically significant association with GC and/or CT cervical infection was the presence of cervical friability (OR = 2-1, P = 0.05). There were trends towards associations with the presence of endocervical mucopus (OR = 2-6, P = 0.06), reporting a new sex partner in the past 3 months (OR = 2-2, P = 0 16) and reporting that a sex partner had an STD-related symptom (OR = 4.4, P = 0413).
Conventional methods of elicitation have severe limitations where sensitive information is being sought, resulting from both self-disclosure and recall bias. The use of diaries largely circumvents both of these problems. Four hundred and three female sex workers based on a section of the Trans-Africa Highway in Kenya completed standard diaries for consecutive 28-day periods. Variables measured included numbers and types of different clients, condom use, occupation of client, movement patterns and days of menses. Mean numbers of sexual partners, liaisons and sex acts and inter-relationships between the variables measured are analysed. The study affirms the value of diaries as an elicitation method for studying transactional sex in a resource-poor setting. Usable diaries were received from 70% of those who had agreed to participate in the study. The diaries yield detailed quantitative data that describe the characteristics and dynamics of transactional sex on a major highway in Africa and provide information that may be used to estimate HIV transmission rates.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.