HIV and Other Sexually Transmitted Infections in a Cohort of Women Involved in High-Risk Sexual Behavior in Kampala, Uganda

Vandepitte, J; Bukenya, Justine; Weiss, Helen A.; Nakubulwa, Susan; Francis, Suzanna C.; Hughes, Peter J.; Hayes, Richard; Grosskurth, Heiner

doi:10.1097/olq.0b013e3182099545

Cited by 131 publications

(194 citation statements)

References 29 publications

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“…The clinic also offers treatment to the women's children under the age of six years. The clinic was set up in 2008 ( Vandepitte et al, 2011) and by the end of 2015 was serving over 3000 women and about 150 of their male partners. Prior to the recent change in guidelines, women found to be HIV-positive were offered Cotrimoxazole until their CD4+ count fell below 350 at which point ART was added to the treatment.…”

Section: Methodsmentioning

confidence: 99%

“…The guidance to provide prompt HIV treatment to key populations, as a part of HIV prevention interventions in Uganda, stems from growing evidence of high HIV prevalence among groups of people engaged in risky sexual behaviour, including female sex workers. In Kampala, recent research has noted high HIV prevalence among women in the general population (Nakku-Joloba et al, 2015), and specifically among women engaged in sex work and their clients (Lindan et al, 2015;Vandepitte et al, 2011). Female sex workers are vulnerable to infection because many have multiple concurrent partners, may not always be able to negotiate condom use, and may also be at risk of violence from clients and regular partners, among other factors (Rutakumwa, Mbonye, Kiwanuka, Bagiire, & Seeley, 2015;Schulkind, Mbonye, Watts, & Seeley, in press;Scorgie et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Test and treat: the early experiences in a clinic serving women at high risk of HIV infection in Kampala

et al. 2016

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At the end of 2013, the Government of Uganda issued guidance recommending provision of AntiRetroviral Treatment (ART) to HIV-positive people in key populations, including female sex workers, regardless of CD4 cell count. We describe the implementation of this new guidance in a clinic serving women at high risk of HIV infection in Kampala. Between July and December 2015, we conducted repeat in-depth interviews with 15 women attending the clinic after the change in guidelines, to explore their perceptions regarding prompt ART initiation. The sample included some women who were HIV-negative and women who had both started and deferred ART. We conducted a data-led thematic analysis of the material from the interviews. A total of 257 of 445 eligible women had started ART; others were undecided or had not returned to the clinic after receiving the new information. Participants recounted varying experiences with the provision of prompt treatment. At an individual level, a history of treatment for opportunistic infections and other illnesses, coupled with relatively poor health, encouraged some to initiate ART promptly. However, knowledge of friends/relatives already on ART who had experienced side effects caused others to delay starting, fearing the same experience for themselves. A number of women questioned why they should start treatment when they were not sick. Situational factors such as work and residence (with many sharing single rooms) caused discomfort among newly diagnosed women who feared disclosure and stigma that would result from taking ART when they were not ill. Alcohol consumption and irregular working hours affected perceptions of future adherence, making prompt ART harder to embrace for some. Our findings show the challenges that influence the delay of treatment initiation, and/or the decision to defer receiving information on ART, with implications for the success of the test and treat programmes and guidelines.ARTICLE HISTORY

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Test and treat: the early experiences in a clinic serving women at high risk of HIV infection in Kampala

et al. 2016

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“…Recent studies in Uganda show high prevalence in women 8,9 , pregnant women and clinical trial populations 10 but population estimates of HSV-2 infection in urban Uganda are few.…”

Section: Introductionmentioning

confidence: 99%

Sero-prevalence of herpes simplex type 2 virus (HSV-2) and HIV infection in Kampala, Uganda

Joloba¹,

Kambugu²,

Wasubire³

et al. 2015

Afr H. Sci.

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Background:Prevalence of herpes simplex type 2 virus (HSV-2) is high worldwide. Previous studies in Uganda were rural or in women. We estimated age and sex-specific sero-prevalence of HSV-2 in Kampala, Uganda. Methods: Using two-stage random sampling stratified on population density, a survey of persons 15-65 years was conducted. Type-specific serological tests for HSV-2, HSV-1(HerpeSelect2 and 1 ELISA), HIV (Rapid tests and ELISA), syphilis (RPR and TPHA) were done. Additional prevalence analysis included post-stratification weighting on the Uganda 2002 Census gender distribution. Results: Among 1124 persons, HSV-2 prevalence was 58% (95% CI: 55, 60), HSV-1; 98% (95% CI: 97.6, 99.1), HIV; 17.7% (95% CI: 14.8, 19.2) and syphilis; 1.7% (95% CI: 1.4, 1.9). Weighted HSV-2 prevalence was 53.8% (Women; 63.8%, men; 43.2%), similar to unweighted data. Weighted HIV prevalence was 20.7% in women, 8.6% in men. Of 165 HIV infected persons, 85.4% had HSV-2. Risk factors for HSV-2 were being a woman (OR 2.0; 95% CI: 1.42, 2.78), age (OR 3.3; 95% CI: 2.43, 4.53), education (OR 1.70; 95% CI: 1.34, 2.34) and HIV (OR 4.5; 95% CI: 2.70, 7.50). Conclusion: Prevalence of HSV-2 and HIV was high especially in women. Syphilis was rare. Awareness of herpes was low. Interventions in young people are needed.

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“…Despite this progress, consistent condom use among FSWs remains low in most settings, with the proportion reporting 100% condom use reported at 26.8% in Kenya and 18.9% in Uganda 2 . The prevalence of HIV and other sexually transmitted infections (STIs) among FSWs remains high in most settings, with HIV prevalence of 33-37% reported among Ugandan FSWs 3,4 . Studies show that truckers engage in sex with multiple sexual partners along the transport routes that they ply, usually without using condoms 5,6 .…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitudes & barriers to condom use among female sex workers and truck drivers in Uganda: a mixed-methods study

Matovu¹,

Ssebadduka²

2014

Afr H. Sci.

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Background: There is limited documentation on knowledge, attitudes and barriers to condom use among female sex workers (FSWs) and truck drivers (truckers). Objective: To explore knowledge, attitudes and barriers to condom use among FSWs and truckers operating along major transport corridors in Uganda Methods: Structured questionnaires were administered to explore FSWs' and truckers' knowledge of and attitudes towards condom use among 259 FSWs and 261 truckers. Qualitative data were collected on barriers to condom use using focus group discussions. Quantitative data were analyzed using SPSS while qualitative data were audio-recorded, transcribed and thematically analyzed. Results: Condom knowledge was high with 97% of FSWs and 95% of truckers agreeing with the statement, "using condoms properly and consistently reduces risk of HIV infection". Attitudes towards condom use were generally favorable with 91% of FSWs and 82% of truckers agreeing with the statement, "condom use is the best method of HIV prevention". Qualitative findings show that poverty, refusal to use condoms by male partners, alcohol use before sex and beliefs that condoms 'kill the mood for sex' remain key barriers to consistent condom use. Conclusions: Consistent condom use among FSWs and truckers is still hampered by economic and relationship factors.

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HIV and Other Sexually Transmitted Infections in a Cohort of Women Involved in High-Risk Sexual Behavior in Kampala, Uganda

Cited by 131 publications

References 29 publications

Test and treat: the early experiences in a clinic serving women at high risk of HIV infection in Kampala

Test and treat: the early experiences in a clinic serving women at high risk of HIV infection in Kampala

Sero-prevalence of herpes simplex type 2 virus (HSV-2) and HIV infection in Kampala, Uganda

Knowledge, attitudes & barriers to condom use among female sex workers and truck drivers in Uganda: a mixed-methods study

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