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High HIV Transmission Risks and Late Diagnosis Among Female Sex Workers in Kampala, Uganda

This study investigates HIV prevalence and related factors among female sex workers (FSWs) in Kampala, Uganda. Among participants, the HIV prevalence was found to be 31.5%, with only 50.4% ever having tested for HIV. A mere 24.6% were aware of their HIV-positive status. Viral load results showed a median of 3,160 copies/ml, with 62.9% having unsuppressed viral loads. The findings highlight the need for improved health literacy, greater access to ART, and targeted interventions to address the high HIV transmission potential in this vulnerable group.

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High HIV Transmission Risks and Late Diagnosis Among Female Sex Workers in Kampala, Uganda

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  1. High HIV Transmission Potential, Late HIV Diagnosis, and Viral Load Among Female Sex Workers (FSW) in Kampala, Uganda

  2. Results • Sex work: 2 years (median, at time of survey participation) • HIV prevalence: 31.5% • Ever HIV tested: 50.4% (HIV-pos only) • Reported having tested HIV-pos: 48.8% • Aware of HIV-pos serostatus: 24.6% • CD4, median: 440 (cells/ul,HIV-pos only) • < 350: 29.6% (among HIV-pos) • < 350, no previous test: 15.4% (among HIV-pos) • Viral load (VL), anti-retroviral treatment (ART) • VL • Median: 3,160 / ml (among HIV-pos) • Unsuppressed: 62.9% (among HIV-pos) • Prevalence unsuppressed VL: 18.9% (all FSW) • Last sex, unprotected, unsuppressed: 2.4% (all FSW) • ART, self reported: 18.1% (HIV-pos only), CD4 < 350: 16.0% • VL among FSW on ART: 1,040 copies/ml (median)

  3. Discussion, conclusion • Very high HIV prevalence (3x female general population) • Short duration of sex work at time of survey participation • Low HIV-positive serostatus knowledge • About half of all HIV-pos FSW who state being on ART have unsuppressed VL • Limitations: • Health literacy to distinguish ART from non-ART care • Did not test for ARV metabolites in plasma • Utility of expanded biomarkers, self-reported HIV service uptake in biobehavioral surveys

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