Progress toward UNAIDS 90-90-90 targets: A respondent-driven survey among female sex workers in Kampala, Uganda

Abstract

BackgroundWe investigated progress towards UNAIDS 90-90-90 targets among female sex workers in Kampala, Uganda, who bear a disproportionate burden of HIV.MethodsBetween April and December 2012, 1,487 female sex workers, defined as women, 15–49 years, residing in greater Kampala, and selling sex for money in the last 6 months, were recruited using respondent-driven sampling. Venous blood was collected for HIV and viral load testing [viral load suppression (VLS) defined as <1,000 copies/mL]. We collected data using audio computer-assisted self-interviews and calculated weighted population-level estimates.ResultsThe median age was 27 years (interquartile range: 23 to 32). HIV seroprevalence was 31.4% (95% confidence interval [CI]: 29.0, 33.7%). Among all female sex workers who tested HIV-positive in the survey (population-level targets), 45.5% (95% CI: 40.1, 51.0) had knowledge of their serostatus (population-level target: 90%), 37.8% (95% CI: 32.2, 42.8) self-reported to be on ART (population-level target: 81%), and 35.2% (95% CI: 20.7, 30.4) were virally suppressed (population-level target: 73%).ConclusionsHIV prevalence among Kampala female sex workers is high, whereas serostatus knowledge and VLS are far below UNAIDS targets. Kampala female sex workers are in need of intensified and targeted HIV prevention and control efforts.

“Vital”: HIV counselling and testing staff’s views of addressing mental health with HIV in Uganda

“…The 90–90-90 targets are due in 2020, and appear unlikely to be met across the board in Uganda, with low rates of detection, treatment and suppression in particular high risk populations [ 16 ]. Thereis an imperative then to optimise testing and counselling protocols, which currently offer no specific guidance in relation to mental health.…”

“…However, there is significant variation between different segments of the population. For example, a study with female sex workers found of the 31.4% of the sample who were HIV positive, just 45.5% knew their status, 37.8% self-reported they were on HIV treatment, and 35.2% were virally suppressed [ 16 ]. There are issues in relation to linkage into care, with studies reporting suboptimal rates of people starting anti-retroviral medications and staying in HIV care.…”

Sustained virological response and drug resistance among female sex workers living with HIV on antiretroviral therapy in Kampala, Uganda: a cross-sectional study

“…In 2017, only 52% of adults in sub-Saharan Africa (SSA) who were living with HIV and on antiretroviral therapy (ART) had achieved virological suppression 2. High HIV prevalence in SSA particularly among key populations including female sex workers (FSWs) poses a major challenge to achieving the targets 3. The critical factors for improving health outcomes of people living with HIV and stopping onward transmission are early ART initiation accompanied by sustained virological suppression 4.…”

Addressing Vulnerable Population Needs in the Last Mile to the elimination of mother to child transmission of HIV: (Re)Claiming the HIV Response for Female Sex Workers and Their Children

“…According to a 2014 global review, approximately 42% of all FSW living with HIV were receiving ART [8]. Among all FSW living with HIV in Kampala, Uganda, 37.8% were on ART and 35.2% were virally suppressed [26]. In Zimbabwe, 43.3% of all FSW living with HIV were on ART and 49.5% were virally suppressed, compared to 66.4% and 58.2% among general population women, respectively [6,27].…”