HIV acquisition prior to entry into formal sex work: inference from next-generation viral sequencing
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Date
2023Author
Neufeld, Bronwyn
Cholette, François
Sandstrom, Paul
Musyoki, Helgar
Ma, Huiting
Kaosa, Shem
Kioko, Japheth
Isac, Shajy
Bhattacharjee, Parinita
Cheuk, Eve
Pickles, Michael
Mwatelah, Ruth
Capiña, Rupert
Daniuk, Christina
Mckinnon, Lyle R
Blanchard, James
Mishra, Sharmistha
Becker, Marissa
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
Objective: To infer the timing of HIV acquisition in relation to self-reported events in the sexual life course of adolescent girls and young women (AGYW) who self-identify as female sex workers (FSW) in Mombasa, Kenya.
Design: Next-generation viral sequencing of samples of AGYW living with HIV in the Transitions study, a cross-sectional bio-behavioural survey of AGYW aged 14-24 years in Mombasa, Kenya.
Method: Dried blood spot specimens were collected from study participants ( n = 37, all FSW). A portion of the HIV pol gene was sequenced using an in-house next-generation sequencing assay for HIV drug resistance mutation genotyping. Estimated time since infection (ETI) was inferred using the HIV EVO web-based tool ( https://hiv.biozentrum.unibas.ch/ETI/ ), and data on self-reported events were obtained from the survey.
Results: The median ETI among FSW was 3.4 (interquartile range = 1.7, 6.3) years, with a median ETI of 1.5 years prior to entry into formal sex work. We estimated that 74.1% (95% confidence interval = 53.7-88.9%) of participants living with HIV and who self-identified as FSW likely acquired HIV prior to self-identification as a sex worker.
Conclusions: Findings suggest a large fraction of prevalent HIV infection among AGYW engaged in sex work stems from acquisition prior to entry into formal sex work. Current HIV prevention programs tailored for sex workers may miss key opportunities for HIV prevention as they are designed to reach women after entry into formal sex work, signaling a need for tailored programs to reach high-risk AGYW earlier on in their sexual life course.
Citation
Neufeld B, Cholette F, Sandstrom P, Musyoki H, Ma H, Kaosa S, Kioko J, Isac S, Bhattacharjee P, Cheuk E, Pickles M, Mwatelah R, Capiña R, Daniuk C, Mckinnon LR, Blanchard J, Mishra S, Becker M; on behalf of the Transitions Study Team. HIV acquisition prior to entry into formal sex work: inference from next-generation viral sequencing. AIDS. 2023 May 1;37(6):987-992. doi: 10.1097/QAD.0000000000003484. Epub 2023 Jan 19. PMID: 36727844; PMCID: PMC10090304.Publisher
University of Nairobi
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Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
- Faculty of Health Sciences (FHS) [10378]
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