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 D.E., Chabata, Sungai T., Magutshwa, Sitholubuhle, Musemburi, Sithembile, Dirawo, Jeffrey, Rice, Brian, Platt, Lucy, Bansi-Matharu, Loveleen, Harriet, Jones, Mharadze, Tendayi, Chiyaka, Tarisai, Mushati, Phillis, Mugurungi, Owen, Yekeye, Raymond, Mpofu, Amon, Phillips, Andrew N., Cowan, Frances ORCID: https://orcid.org/0000-0003-3087-4422 and Hargreaves, James R. (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, Vol 36, Issue 8, pp. 1141-1150.

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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.

Item Type:	Article
Subjects:	WA Public Health > WA 30 Socioeconomic factors in public health (General) WC Communicable Diseases > Sexually Transmitted Diseases > WC 140 Sexually transmitted diseases WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.6 Prevention and control WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.7 Psychosocial aspects
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1097/QAD.0000000000003198
Depositing User:	Mary Creegan
Date Deposited:	21 Apr 2022 10:45
Last Modified:	16 Feb 2023 02:02
URI:	https://archive.lstmed.ac.uk/id/eprint/20263

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