International Centre for Reproductive Health Kenya, Mombasa, Kenya.
Burnet Institute, Melbourne, Australia.
Int J STD AIDS. 2020 Dec;31(14):1389-1397. doi: 10.1177/0956462420950571. Epub 2020 Oct 25.
Over 20 years, interventions have targeted HIV among female sex workers (FSWs) in Kenya given their central role in new infections. To determine the effects of these interventions, we assessed the prevalence and correlates of HIV among a random sample of FSWs and modelled prevalence estimates from studies since 1993. FSWs aged 16-34 years were enrolled through multi-stage sampling. Regression models identified correlates of HIV infection. Generalised linear mixed modelling estimated temporal changes in prevalence between 1993 and 2016. 882 FSWs were enrolled. Prevalence rose from 3.6% among 16-20-year-olds to 31.6% among 31-34-year-old FSWs. Those aged 31 to 34 years had greater odds of HIV compared to those 16 to 20 years (AOR 14.2, 95% CI, 5.5-36.8). Infection was less prevalent among FSWs with tertiary education compared to those with primary or no education (AOR 0.23, 95% CI, 0.07-0.78). There was an overall 30% reduction in prevalence from 1993 to 2016 with an average annual decline of 3%. About one in ten FSWs in Mombasa are currently infected with HIV. Considering FSWs' central role in sustaining population-level infections, these initiatives require continued support, focusing on reducing transmission from older FSWs and those with less education.
二十多年来,肯尼亚的女性性工作者(FSW)一直是新感染艾滋病病毒的主要人群,针对这一人群的干预措施旨在控制艾滋病病毒的传播。为了评估这些干预措施的效果,我们评估了随机抽样的 FSW 中 HIV 的流行率和相关因素,并对 1993 年以来的研究进行了流行率估计模型分析。年龄在 16-34 岁的 FSW 通过多阶段抽样纳入研究。回归模型确定了 HIV 感染的相关因素。广义线性混合模型估计了 1993 年至 2016 年期间流行率的时间变化。共纳入 882 名 FSW。16-20 岁的 FSW 中 HIV 流行率为 3.6%,而 31-34 岁的 FSW 中 HIV 流行率上升至 31.6%。31-34 岁的 FSW 比 16-20 岁的 FSW 感染 HIV 的几率更高(AOR 14.2,95%CI,5.5-36.8)。与具有小学或无教育程度的 FSW 相比,具有高等教育程度的 FSW 感染 HIV 的几率更低(AOR 0.23,95%CI,0.07-0.78)。1993 年至 2016 年期间,总体 HIV 流行率下降了 30%,平均每年下降 3%。蒙巴萨目前约有十分之一的 FSW 感染了 HIV。考虑到 FSW 在维持人群感染方面的核心作用,这些干预措施需要继续得到支持,重点是减少来自年龄较大的 FSW 和教育程度较低的 FSW 的传播。