Magister Public Health - MPH / Background: HIV/AIDS remains a major public health issue that is affecting all population
groups and communities in Zambia. Among the most affected groups are key populations
(KPs) such as female sex workers. KPs are considered at high risk of contracting HIV but have
limited access to HIV services and retention in care due to internalized stigma, discrimination,
criminalization, and negative attitudes towards HIV treatment. Under the USAID Open Doors
project in Zambia, KPs access comprehensive HIV prevention, care and treatment services.
The test and treat strategy is implemented by the project in support of the UNAIDS 90-90-90
targets by 2020 to diagnose 90% of people living with HIV, put 90% of them on treatment, and
for 90% of them to have suppressed viral load.
Aim: This study aimed to determine retention in care among female sex workers (FSWs) in
the first six months after ART initiation using the HIV care cascade.
Methodology: A retrospective cohort study was conducted of all new HIV positive female sex
workers (FSWs) initiated on ART between October 2018 and June 2019 (9 months period)
based on the electronic records. Data were extracted from SmartCare, an electronic health
record system used by the ART clinic. Microsoft Excel and Epi-Info 7 software were used for
data entry and analysis. Kaplan–Meier survival analysis was conducted to examine differences
in retention rates.
Results: A total of 205 FSWs were initiated on ART, out of which 180 were active on ART
(36 youths and 144 adults) and 25 were lost to follow-up (four youths and 21 adults) during
the 9 months study period. Of the 180 FSWs active on ART, 36 were FSWs aged 18 – 24 years
(youths) representing 90% retained in care while 144 were FSWs aged 25 – 42 years (adults)
with 87% being retained on ART treatment. Retention in ART care was not significantly
different in the survival curves between the age groups of FSW youths and FSW adults during
the study period (p-value = 0.637). Retention in ART care was not statistically significant for
education (p-value = 0.481), marital status (p-value = 0.545), and occupation (p-value = 0.169).
Conclusion: Retention in ART care among FSWs was 88%. However, there were no
significant differences by age group identified in this study. While this study shows 88%
retention rate among FSWs, it will be used as a baseline in meeting the UNAIDS 90-90-90
goals.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uwc/oai:etd.uwc.ac.za:11394/8800 |
| Date | January 2021 |
| Creators | Bwalya, Clement Mudala |
| Contributors | Nyembezi, Anam |
| Publisher | University of the Western Cape |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Rights | University of the Western Cape |
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