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坦桑尼亚针对女性性工作者的社区抗逆转录病毒治疗(ART)服务:干预模式与基线调查结果

Community-based antiretroviral therapy (ART) delivery for female sex workers in Tanzania: intervention model and baseline findings.

作者信息

Vu Lung, Tun Waimar, Apicella Louis, Casalini Caterina, Makyao Neema, Tsang Samantha, Michael Denna, Koppenhaver Todd, Mlanga Erick

机构信息

HIV and AIDS Program, Population Council, Washington, DC, USA.

HIV and AIDS Program, Population Council, Dar es Salaam, Tanzania.

出版信息

AIDS Care. 2020 Jun;32(6):729-734. doi: 10.1080/09540121.2019.1640846. Epub 2019 Jul 12.

Abstract

To increase linkage to and retention in antiretroviral therapy (ART) care, we piloted a community-based, ART service delivery intervention for female sex workers (FSWs). At baseline, we recruited and collected data from 617 FSWs (intervention: 309; comparison: 308) who were HIV positive and not on ART. This paper presents (1) the description of the intervention model, and (2) key descriptive and bivariate-level findings of the baseline FSW cohort. The data showed more than half of FSWs had a non-paying sex partner, and less than one-third used a condom at last sex with paying and non-paying clients, which suggest potentially high levels of HIV transmission. In addition, there is a gap in HIV testing and treatment because one-third learned about their HIV-positive status only at study enrollment, and among FSWs who had known their status for more than a month, half had not registered in care. This substantiates the importance of timely HIV diagnosis and treatment. A community-based ART program may serve as an important strategy in closing the HIV care and treatment gap for FSWs.

摘要

为了提高抗逆转录病毒治疗(ART)服务的联系率和留存率,我们针对女性性工作者(FSW)开展了一项基于社区的ART服务提供干预试点。在基线期,我们招募了617名HIV阳性且未接受ART治疗的FSW(干预组:309名;对照组:308名)并收集了她们的数据。本文介绍了(1)干预模式的描述,以及(2)基线期FSW队列的关键描述性和双变量水平的研究结果。数据显示,超过一半的FSW有非付费性伴侣,不到三分之一的人在与付费和非付费客户的最后一次性行为中使用了避孕套,这表明HIV传播风险可能很高。此外,HIV检测和治疗存在差距,因为三分之一的人仅在研究入组时才得知自己HIV呈阳性,在已知感染状态超过一个月的FSW中,有一半未登记接受治疗。这证实了及时进行HIV诊断和治疗的重要性。基于社区的ART项目可能是缩小FSW的HIV治疗差距的一项重要策略。

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