HIV-1 Incidence Rates and Risk Factors in Agricultural Workers and Dependents in Rural Kenya: 36-Month Follow-Up of the Kericho HIV Cohort Study

Shaffer, Douglas; Ngetich, Ignatius K; Bautista, Christian T.; Sawe, Frederick K.; Renzullo, Philip O.; Scott, Paul T.; Kibaya, Rukia; Imbuki, Kennedy; Michael, Nelson L.; Birx, Deborah L.; Wasunna, Monique; Robb, Merlin L.

doi:10.1097/qai.0b013e3181bcdae0

Cited by 15 publications

(23 citation statements)

References 19 publications

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“…Ten studies provide data on men, four of which provide data exclusively on young men. Three studies provided measures of association that were not sex disaggregated [16–18]. Overall, 14 studies (17 papers) were cross-sectional or repeated cross-sectional and provide HIV prevalence measures, whereas two cohort studies provided HIV incidence measures.…”

Section: Resultsmentioning

confidence: 99%

“…Six of the studies drew from a more nuanced definition of transactional sex (sex motivated by material gain/gifts/money) that better distinguishes the practice from sex work [9,10,19–22,24,27,28]. Seven studies used a conventional measurement approach, asking about “sex in exchange for gifts or money” [18,23,25,29–32], and another two studies did not clearly state their measurement approach, but described transactional sex as distinct from sex work in the text of the article [16,17]. We included one study that measured transactional sex as “ever had sex for money” [26].…”

Section: Resultsmentioning

confidence: 99%

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Transactional sex and risk for HIV infection in sub‐Saharan Africa: a systematic review and meta‐analysis

Wamoyi

Stobeanau

Bobrova

et al. 2016

Journal of the International AIDS Society

175

142

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IntroductionYoung women aged 15 to 24 years in sub-Saharan Africa continue to be disproportionately affected by HIV. A growing number of studies have suggested that the practice of transactional sex may in part explain women's heightened risk, but evidence on the association between transactional sex and HIV has not yet been synthesized. We set out to systematically review studies that assess the relationship between transactional sex and HIV among men and women in sub-Saharan Africa and to summarize the findings through a meta-analysis.MethodsThe search strategy included 8 databases, hand searches in 10 journals, and searches across 17 websites and portals for organizations as informed by expert colleagues. A systematic review of cross-sectional and longitudinal studies was carried out for studies on women and men who engage in transactional sex published up through 2014. Random effects meta-analysis was used to further examine the relationship between transactional sex and prevalent HIV infection across a subset of studies with the same exposure period. Analyses were conducted separately for men and women.ResultsNineteen papers from 16 studies met our inclusion criteria. Of these 16 studies, 14 provided data on women and 10 on men. We find a significant, positive, unadjusted or adjusted association between transactional sex and HIV in 10 of 14 studies for women, one of which used a longitudinal design (relative risk (RR)=2.06, 95% confidence interval (CI): 1.22 –3.48). Out of 10 studies involving men, only 2 indicate a positive association between HIV and transactional sex in unadjusted or adjusted models. The meta-analysis confirmed general findings from the systematic review (unadjusted meta-analysis findings are significant for women (n=4; pooled odds ratio (OR)=1.54, 95% CI: 1.04–2.28; I2=42.5%, p=0.156), but not for men (n=4; pooled OR=1.47, 95% CI: 0.85–2.56; I2=50.8%, p=0.107).ConclusionsTransactional sex is associated with HIV among women, whereas findings for men were inconclusive. Given that only two studies used a longitudinal approach, there remains a need for better measurement of the practice of transactional sex and additional longitudinal studies to establish the causal pathways between transactional sex and HIV.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Transactional sex and risk for HIV infection in sub‐Saharan Africa: a systematic review and meta‐analysis

Wamoyi

Stobeanau

Bobrova

et al. 2016

Journal of the International AIDS Society

175

142

View full text Add to dashboard Cite

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“…All study types were included (e.g., crosssectional, case-control, and cohort) irrespective of the measure of alcohol use employed, as long as a "no-use" referent was available for comparison. Five additional studies were identified by the updated literature review (Adoga et al, 2009;Kalichman, Cain, & Simbayi, 2010;Norris, Kitali, & Worby, 2009;Shaffer et al, 2010;Williams et al, 2009) bringing the total number of studies included in this meta-analysis to 35 (see Table 3). …”

Section: Methods Literature Reviewmentioning

confidence: 99%

“…There were a few notable exceptions: (1) Ayisi et al (2000) reported adjusted and unadjusted risk ratios, (2) Talbot et al (2002) reported adjusted and unadjusted prevalence ORs, and (3) all but two of the cohort studies (Allen et al, 1992;Kalichman et al, 2010) provided rate ratios or data for calculation of a rate ratio (Kapiga et al, 1998;Shaffer et al, 2010;Zablotska et al, 2006Zablotska et al, , 2009. In these instances, the measure of association reported by the authors was used in order to retain the benefit of adjusted rate/risk ratios, although separate analyses were conducted based on study design (e.g., case-control vs. cohort studies).…”

Section: Data Abstractionmentioning

confidence: 99%

An update on alcohol use and risk of HIV infection in sub-Saharan Africa: Meta-analysis and future research directions

Woolf‐King

Steinmaus

Reingold

et al. 2013

IJADR

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Aims: Sub-Saharan Africa is disproportionately affected by HIV/AIDS, and growing evidence suggests that alcohol consumption is a co-occurring problem in the region. We conducted a meta-analysis on studies of alcohol use and HIV infection in subSaharan Africa in order to assess associations, evaluate heterogeneity in the literature, identify susceptible subgroups, and suggest avenues for future research.Design: We performed a systematic review, including published review articles and electronic database searches, and identified 35 studies on alcohol use and HIV. Setting and participants:All of the studies included in the meta-analysis occurred with adults in sub-Saharan Africa.Measurements: Pooled odds ratio (OR) estimates were calculated using both the fixed inverse variance weighting method and the random effects method when evidence of heterogeneity was present. Findings:The pooled OR estimate for all studies was 1.61 (95% CI: 1.44-1.80). The association between alcohol use and prevalence or incident HIV infection was particularly large among samples who reported problem drinking (OR = 2.17, 95% CI: 1.64-2.87) and drinking in sexual contexts (OR = 1.79, 95% CI: 1.55-2.06). Some evidence of publication bias was present; however, the OR remained statistically significant in small and large studies and with population-based and high-risk samples.

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“…One population is persons with multiple partners, including sex workers [41][42][43][44][45][46] and MSM in which incidence ranges as high as 8-10 per 100 person years [47,48]. The other is married or cohabiting couples in which one partner is HIV positive and one is HIV negative, who are at high risk even after counseling and condom provision, a type of cohort that has contributed enormously to our understanding of heterosexual transmission as well as the course of HIV infection, with incidence in the range of 2-7 per 100 person years and very high rates of follow-up [49][50][51].…”

Section: Human Efficacy Trials: Considerations Relating To Populationsmentioning

confidence: 99%

HIV vaccines: current status worldwide and in Africa

Fast¹,

Kaleebu²

2010

Aids

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Since HIV-1 was identified, development of a preventive vaccine has been a major goal. Significant progress toward that goal has been made by 2010. In macaques, a vigorous T effector cell response has protected some animals from disease caused by simian immunodeficiency virus (SIV). Broadly, neutralizing human anti-HIV antibodies have been isolated and their structures, and targets are rapidly being elucidated. For the first time an AIDS vaccine has shown modest protective efficacy in a human clinical trial. To reach the final goal, there is a need for a coordinated global effort, including a range of approaches including novel high-throughput screening techniques, X-ray crystallography, and monoclonal antibody isolation, analysis of T cell responses and their impact on disease progression, human epidemiology, as well as targeted studies in nonhuman primates. African research teams as well as cohorts of healthy volunteers and HIV-infected individuals have contributed to HIV vaccine research and development in many important ways. It is essential that this work continue to speed the development and deployment of a vaccine suitable for African populations.

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HIV-1 Incidence Rates and Risk Factors in Agricultural Workers and Dependents in Rural Kenya: 36-Month Follow-Up of the Kericho HIV Cohort Study

Cited by 15 publications

References 19 publications

Transactional sex and risk for HIV infection in sub‐Saharan Africa: a systematic review and meta‐analysis

Transactional sex and risk for HIV infection in sub‐Saharan Africa: a systematic review and meta‐analysis

An update on alcohol use and risk of HIV infection in sub-Saharan Africa: Meta-analysis and future research directions

HIV vaccines: current status worldwide and in Africa

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