Imperial College London
Alternate

ProfessorSimonGregson

Faculty of Medicine, School of Public Health

Professor in Demography and Behavioural Science
 
 
 
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Contact

 

+44 (0)20 7594 3279s.gregson

 
 
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Location

 

LG27Praed StreetSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Rhead:2018:10.1136/bmjopen-2017-018751,
author = {Rhead, R and Elmes, J and Otobo, E and Nhongo, K and Takaruza, A and White, P and Nyamukapa, C and Gregson, S},
doi = {10.1136/bmjopen-2017-018751},
journal = {BMJ Open},
title = {Do female sex workers have lower uptake of HIV treatment services than non-sex-workers? A cross-sectional study from East Zimbabwe},
url = {http://dx.doi.org/10.1136/bmjopen-2017-018751},
volume = {8},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective Globally, HIV disproportionately affects female sex workers (FSWs) yet HIV treatment coverage is suboptimal. To improve uptake of HIV services by FSWs, it is important to identify potential inequalities in access and use of care and their determinants. Our aim is to investigate HIV treatment cascades for FSWs and non-sex workers (NSWs) in Manicaland province, Zimbabwe, and to examine the socio-demographic characteristics and intermediate determinants that might explain differences in service uptake.Methods Data from a household survey conducted in 2009–2011 and a parallel snowball sample survey of FSWs were matched using probability methods to reduce under-reporting of FSWs. HIV treatment cascades were constructed and compared for FSWs (n=174) and NSWs (n=2555). Determinants of service uptake were identified a priori in a theoretical framework and tested using logistic regression.Results HIV prevalence was higher in FSWs than in NSWs (52.6% vs 19.8%; age-adjusted OR (AOR) 4.0; 95% CI 2.9 to 5.5). In HIV-positive women, FSWs were more likely to have been diagnosed (58.2% vs 42.6%; AOR 1.62; 1.02–2.59) and HIV-diagnosed FSWs were more likely to initiate ART (84.9% vs 64.0%; AOR 2.33; 1.03–5.28). No difference was found for antiretroviral treatment (ART) adherence (91.1% vs 90.5%; P=0.9). FSWs’ greater uptake of HIV treatment services became non-significant after adjusting for intermediate factors including HIV knowledge and risk perception, travel time to services, physical and mental health, and recent pregnancy.Conclusion FSWs are more likely to take up testing and treatment services and were closer to achieving optimal outcomes along the cascade compared with NSWs. However, ART coverage was low in all women at the time of the survey. FSWs’ need for, knowledge of and proximity to HIV testing and treatment facilities appear to increase uptake.
AU  - Rhead,R
AU  - Elmes,J
AU  - Otobo,E
AU  - Nhongo,K
AU  - Takaruza,A
AU  - White,P
AU  - Nyamukapa,C
AU  - Gregson,S
DO  - 10.1136/bmjopen-2017-018751
PY  - 2018///
SN  - 2044-6055
TI  - Do female sex workers have lower uptake of HIV treatment services than non-sex-workers? A cross-sectional study from East Zimbabwe
T2  - BMJ Open
UR  - http://dx.doi.org/10.1136/bmjopen-2017-018751
UR  - http://hdl.handle.net/10044/1/54522
VL  - 8
ER  -
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