Maggie L. Shaw
As of 2017, 184,718 boyish developed women and men were active with HIV in Kenya, for an anniversary prevalence of 2.61% and 1.34%, respectively. Changeable sex workers are at college accident of application HIV.
According to abstraction after-effects appear aftermost anniversary in the Journal of Acquired Immune Deficiency Syndromes (JAIDS), AGYW are affiliated to 23.7% of new HIV infections in Kenya—most actuality undiagnosed—despite accounting for aloof 18.4% of the developed citizenry in the country. And the burghal of Mombasa, Kenya, is advised a hotspot in the HIV/AIDS catching in sub-Saharan Africa. Together with Nairobi, HIV diagnoses there jumped from 4707 in 2013 to 7145 in 2015—an about 52% admission in aloof 2 years.
The JAIDS board acclaimed that “the aftereffect of undiagnosed HIV amid AGYW is basic HIV, appropriately attached the alone bloom and the population-level manual allowances of able antiretroviral treatment.” Using abstracts on Mombasa, they looked into how venue-based (ie, location-based) testing ability be acclimated to admission the all-embracing HIV testing and apprehension amount of AGYW who self-classify as sex workers, acclamation abeyant barriers to admission to affliction in the action (eg, stigma, costs, battle with school/work schedule).
Their surveyed citizenry consisted of 2 groups of cisgender females age-old 14 to 24 years: boyish females who advertise sex (n = 365) and those who did not (n = 828), all with at atomic 1 accident of vaginal or anal sex in their lifetime. The hotspots they advised consisted of locations that changeable sex workers and non–sex workers frequented, such as schools, arcade malls, and parks. Outreach workers and associate educations conducted, with consent, in-person interviews, as able-bodied as on-site HIV testing in the anatomy of calm broiled claret specimens, which were acclimated to affirm ache status.
Overall, 89.3% of the AGYW consented to be tested, and their average age was 19 years (interquartile range, 17-21 years). Amid the abstraction cohorts, 10.1% of the sex workers and 3.6% of the non–sex workers activated absolute for HIV (P <.001), but aloof 27.0% and 30.0%, respectively, knew their cachet (P = .79).
For the hotspots studied, the abstraction authors estimated that 627 AGYW (range, 310-1081) remained undiagnosed. Accounting for the AGYW who banned to accommodate their HIV cachet back they were approached at a hotspot, the board bent that hotspot-based testing could precipitously abate the undiagnosed citizenry from 71.6% (95% CI, 59.3%-82.0%) to 20.2% (95% CI, 17.6%-23.0%). That’s a abutting to 72% reduction. However, overall, 74.0% of AGYW sex workers and 84.2% of non–sex workers (P <.001) did not apperceive HIV casework were available.
“Our allegation advance hotspot-based testing strategies represent an beginning befalling to admission HIV diagnoses amid AGYW active with HIV,” the authors noted. “Recommendations for testing—across key and added antecedence populations such as AGYW—include the accouterment of a ‘safe space,’ testing chargeless of coercion, and employing approaches that abode stigma and bigotry accompanying to sex assignment in accepted and to animal action amid youth.”
One absolute aftereffect is the aerial ante of those with an HIV analysis who claimed to be on HIV analysis at the time they were interviewed: 80.0% of sex workers and 77.8% of non–sex workers. In addition, an all-embracing 71.4% self-reported an HIV analysis in the antecedent year, and this cardinal was college amid sex workers than non–sex workers (85.4% vs 65.4%; P <.001).
Ma H, Wang L, Gichangi P, et al. Venue-based HIV testing at sex assignment hotspots to ability boyish girls and boyish women active with HIV: a cross-sectional abstraction in Mombasa, Kenya [published online April 6, 2020]. J Acquir Immune Defic Syndr. doi: 10.1097/QAI.0000000000002363.
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