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High level of HIV drug resistance and virological non-suppression among female sex workers in Ethiopia: a nation-wide cross-sectional study
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4 15 2022
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Source: J Acquir Immune Defic Syndr. 89(5):566-574
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Details:
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Alternative Title:J Acquir Immune Defic Syndr
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Personal Author:
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Description:Objective:
To determine viral load non-suppression (VLN) rates, HIV drug resistance (HIVDR) prevalence and associated factors among female sex workers (FSWs) in Ethiopia.
Methods:
A cross-sectional biobehavioural survey was conducted among FSWs in 11 cities in Ethiopia in 2014. Whole blood was collected and HIVDR genotyping was done. Logistic regression analysis was used to identify factors associated with VLN and HIVDR.
Results:
Among 4900 participants, 1172 (23.9%) were HIV-positive, and 1154 (98.5%) had a VL result. Participants were categorized into ART (n=239) and ART-naïve (n=915) groups based on self-report. From the 521 specimens (ART, 59; ART-naïve, 462) with VL ≥1000 copies/mL, genotyping was successful for 420 (80.6%), and 92 (21.9%) had drug resistance mutations (DRMs). Pre-treatment drug resistance (PDR) was detected in (63/381) 16.5% ART-naïve participants. Nucleoside, non-nucleoside reverse transcriptase inhibitors (NRTIs, NNRTI), and dual-class DRMs were detected in 40 (10.5%), 55 (14.4%), and 35 (9.2%) of the participants, respectively. Among 239 on ART, 59 (24.7%) had VLN. Genotyping was successfully performed for 39 (66.1%). DRMs were detected in 29 (74.4%). All 29 had NNRTI, 23 (79.3%) had NRTI or dual-class DRMs. VLN was associated with age ≥35 years, CD4+ T-cell count <350 cells/mm3 and being forced into selling sex. PDR and acquired drug resistance was associated with CD4+ T-cell count <350 cells/mm3 (p<0.001).
Conclusions:
The high VLN and HIVDR rates among FSWs underscores the need for targeted interventions to improve ART access and virological monitoring to maximize the benefit of ART and limit the spread of HIV and HIVDR.
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Source:
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Pubmed ID:34966147
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Pubmed Central ID:PMC9058170
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Funding:
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Volume:89
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Issue:5
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