Men who have sex with men in Senegal are highly infected with HIV and other STI. Intervention programs targeting this population are urgently needed, given their particular vulnerability and because infections are likely to disseminate into the general population given the high proportion of bisexual activity in this community.
The objective of this article is to report seroprevalences on HIV and herpes simplex virus 2 (HSV-2) in female sex workers (FSW) and in two sentinel populations of pregnant women living in Senegal. Serosurveys of HIV and HSV-2 were conducted in two unselected sentinel populations from Dakar, Senegal, and its provinces, including in 2003 only pregnant women and 2006 pregnant women and FSW. The population study involved 888 pregnant women and 604 FSW. In pregnant women, HIV and HSV-2 seroprevalences were, respectively, 1.01% and 15.65%. There was no association between HSV-2 and HIV infection, whatever the age. In contrast, the seroprevalence of HIV infection in the group of FSW was high, reaching 22.9% in women over 30 years old. FSW above 20 years of age harboured much higher HSV-2 seroprevalences that those found in pregnant women of similar age groups. In FSW, strong associations between HSV-2 and age, and among HSV-2 and HIV-1 as well HIV-2, were evidenced. In conclusion, HIV epidemic remains concentrated in high-risk groups of the Senegalese population, such as the FSW population in which the seroprevalence of HSV-2 infection is very high. Intervention against STI including HSV-2 is urgently needed to prevent the spreading of HIV epidemic.
BackgroundSensitisation campaigns to increase voluntary counselling and testing (VCT) are important tools in the fight against the HIV/AIDS virus in Africa. For the case of Senegal, we examine whether funding community based organizations can be an effective means of increasing VCT adoption and modifying the subsequent behavior of HIV-positive individuals. MethodWe analyze two randomly introduced HIV/AIDS sensitisation campaigns by exploiting routinely-collected administrative data on standard HIV/AIDS indicators from 52 health districts. We distinguish between two treatment groups: in a first set of randomly-chosen health districts, community organizations received funding and carried out traditional HIV/AIDS sensitisation, whereas in a second randomlychosen treatment group, they did so by using a new peer-mentoring mechanism; the remaining health districts were assigned to the control group and received no funding. FindingsOur results indicate that: (i) funded peer mentoring doubles the number of individuals who get tested, who follow pre-test counselling and who pick up their test
BackgroundWith the expansion of Prevention of Mother to Child Transmission (PMTCT) services in Senegal, there is growing interest in using PMTCT program data in lieu of conducting unlinked anonymous testing (UAT)-based ANC Sentinel Surveillance. For this reason, an evaluation was conducted in 2011–2012 to identify the gaps that need to be addressed while transitioning to using PMTCT program data for surveillance.MethodsWe conducted analyses to assess HIV prevalence rates and agreements between Sentinel Surveillance and PMTCT HIV test results. Also, a data quality assessment of the PMTCT program registers and data was conducted during the Sentinel Surveillance period (December 2011 to March 2012) and 3 months prior. Finally, we also assessed selection bias, which was the percentage difference from the HIV prevalence among all women enrolled in the antenatal clinic and the HIV prevalence among women who accepted PMTCT HIV testing.ResultsThe median site HIV prevalence using routine PMTCT HIV testing data was 1.1% (IQR: 1.0) while the median site prevalence from the UAT HIV Sentinel Surveillance data was at 1.0% (IQR: 1.6). The Positive per cent agreement (PPA) of the PMTCT HIV test results compared to those of the Sentinel Surveillance was 85.1% (95% CI 77.2–90.7%), and the percent-negative agreement (PNA) was 99.9% (95% CI 99.8–99.9%). The overall HIV prevalence according to UAT was the same as that found for women accepting a PMTCT HIV test and those who refused, with percent bias at 0.00%. For several key PMTCT variables, including “HIV test offered” (85.2%), “HIV test acceptance” (78.0%), or “HIV test done” (58.8%), the proportion of records in registers with combined complete and valid data was below the WHO benchmark of 90%.ConclusionsThe PPA of 85.1 was below the WHO benchmarks of 96.6%, while the combined data validity and completeness rates was below the WHO benchmark of 90% for many key PMTCT variables. These results suggested that Senegal will need to reinforce the quality of onsite HIV testing and improve program data collection practices in preparation for using PMTCT data for surveillance purposes.
stage III or IV irrespective of CD4 cell count, or at any WHO stage with CD4 cell counts ≤ 350 cells/µl. Results Of the 4827 adults patients included in the analysis, 32.1% were male and the median age was 43 years. 67.9% were female and the median age was 41 years. 94.9% of patient were HAART naïve, 5.1% were transfer in. 3913(81.1%) of 4827 patients were still on HAART after 5 years of follow-up. 18.9% difference is attributed to lost to follow-up, patient transferred out and reported deaths. Among the patients with adherence assessment reported, 96.6% of patients had adherence level > 95%, 1.5% had adherence level of 85%-95% and 1% had adherence < 85%. 74.5% patients received their HAART refills at the CDDP, 23.8% received refills at the facility, and 1.4% received refills at their homes. Conclusions These positive results after 5 years of initiating HAART in patients with advanced HIV disease demonstrate efficacy of HAART in resource-limited settings. Additional support is required to ensure timely HAART among adults.
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