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Estimation of HIV incidence from analysis of HIV prevalence patterns by age and years since starting sex work among female sex workers in Zimbabwe

Ali, M Sanni; Wit, Mariken DE; Chabata, Sungai T; Magutshwa, Sitholubuhle; Musemburi, Sithembile; Dirawo, Jeffrey; Rice, Brian; ... Hargreaves, James R; + view all (2022) Estimation of HIV incidence from analysis of HIV prevalence patterns by age and years since starting sex work among female sex workers in Zimbabwe. AIDS , 36 (8) pp. 114-1150. 10.1097/QAD.0000000000003198. Green open access

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Abstract

OBJECTIVES: To estimate HIV incidence among female sex workers (FSW) in Zimbabwe: using HIV prevalence by age and number of years since started selling sex (YSSS). DESIGN: We pooled data from FSW aged 18-39 participating in respondent-driven sampling surveys conducted in Zimbabwe between 2011-2017. METHODS: For each year of age, we estimated: HIV prevalence (Pt) and the change in HIV prevalence from the previous age (Pt-Pt-1). We then estimated the rate of new HIV infections during that year of age: It = Pt-Pt-1/(1-Pt-1), and calculated HIV incidence for 18-24 and 25-39 year-olds separately as the weighted average of It. We estimated HIV incidence for FSW 1-5 years and 6-15 years since first selling sex using the same approach, and compared HIV prevalence among FSW first selling sex at their current age with the general population. RESULTS: Among 9,906 women, 50.2% were HIV positive. Based on HIV prevalence increases by age, we estimated an HIV incidence of 6.3/100 person-years at risk (pyar) (95%CI 5.3,7.6) among 18-24 year-olds, and 3.3/100 pyar (95% CI 1.3,4.2) among 25-39 year-olds. Based on prevalence increases by YSSS, HIV incidence was 5.3/100 pyar (95% CI 4.3,8.5) between 1-5 years since first selling sex, and 2.1/100 pyar (95% CI -1.3, 7.2) between 6-15 years. CONCLUSIONS: Our analysis is consistent with very high HIV incidence among FSW in Zimbabwe, especially among those who are young and recently started selling sex. There is a critical need to engage young entrants into sex work in interventions that reduce their HIV risk.

Type: Article
Title: Estimation of HIV incidence from analysis of HIV prevalence patterns by age and years since starting sex work among female sex workers in Zimbabwe
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/QAD.0000000000003198
Publisher version: https://doi.org/10.1097/QAD.0000000000003198
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10144207
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