High Burden of HIV, Syphilis and HSV-2 and Factors Associated with HIV Infection Among Female Sex Workers in Tanzania: Implications for Early Treatment of HIV and Pre-exposure Prophylaxis (PrEP)

Abstract

This paper estimates population-based prevalence of HIV, syphilis, HSV-2 and factors influencing HIV infection using a national sample of 1914 female sex workers (FSWs) in 7 regions in Tanzania. Additionally, HIV incidence was estimated by comparing biological HIV results with self-reported HIV status. The average HIV prevalence among FSWs in all 7 regions was 28%, ranging from 14% in Tabora to 38% in Shinyanga. HIV incidence was found to be 13 per 100 person-years. Syphilis prevalence was 8% with significantly higher burden found in Iringa (11%), Mbeya (13%), and Shinyanga (12%). Nearly 60% of the study population was infected with HSV-2. The high HIV prevalence and incidence coupled with suboptimal condom use indicate an urgent need to roll out the "Treat-All" approach and provide antiretroviral therapy to FSWs living with HIV regardless of their CD4 count. In addition, antiretroviral-based prevention technologies such as oral pre-exposure prophylaxis and microbicides should be piloted and evaluated.

Structural, interpersonal, psychosocial, and behavioral risk factors for HIV acquisition among female bar workers in Dar es Salaam, Tanzania

“…The prevalence of HIV among FBWs (7.1%) was also lower than a recent estimate of HIV prevalence among FSWs in DSM (32%) (Vu and Misra, 2018) .…”

Psychosocial correlates of regular syphilis and HIV screening practices among female sex workers in Uganda: a cross-sectional survey

“…Evidence shows that in 2014, STI prevalence ranged from 24.9% to 77.5%; between half and two-thirds of FSW have a curable STI at any one time, 30% have reactive syphilis serology and 10% or more have an active genital ulcer [14]. A recent study in Tanzania also found high burden of syphilis (8%) and herpes simplex (HSV) type 2 (60%) [15]. Similar findings have been reported in Ugandan studies that have found high burden of STIs including herpes simplex virus (HSV) type 2 (80%), gonorrhea (13%) and chlamydia (9%) [8, 10].…”

“…There is low uptake of STI and HIV screening services among FSW in Uganda; only 53% of FSW had previously tested for HIV in one study [8]. Limited data are available regarding regularity and correlates of STI and HIV screening among FSW in SSA [8, 15, 30].…”

Ethnomedicinal Wisdom

“…Viruses are acellular ultra-microscopic metabolically inert obligate intracellular parasites of cellular hosts (Chattopadhyay et al, 2009b), associated with diverse diseases and are threats to human, wildlife, and livestock (Malosh et al, 2017;Marston et al, 2017;Prkno et al, 2017;Akbari and Elmi, 2017;Vu and Misra, 2018). Many are incurable and have no effective antiviral drugs except a very few (forty) US FDA approved antiviral drugs available for the management of some viral diseases.…”