Open AccessChanges in engagement in HIV prevention and care services among female sex workers during intensified community mobilization in 3 sites in Zimbabwe, 2011 to 2015
Author(s) -
NdoriMharadze Tendayi,
Fearon Elizabeth,
Busza Joanna,
Dirawo Jeffrey,
Musemburi Sithembile,
Davey Calum,
Acharya Xeno,
Mtetwa Sibongile,
Hargreaves James R,
Cowan Frances
Publication year - 2018
Publication title -
journal of the international aids society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.724
H-Index - 62
ISSN - 1758-2652
DOI - 10.1002/jia2.25138
Subject(s) - medicine , mobilization , human immunodeficiency virus (hiv) , community mobilization , environmental health , gerontology , family medicine , economic growth , archaeology , economics , history
‘Sisters with a Voice’, Zimbabwe's nationally scaled comprehensive programme for female sex workers ( FSW s), intensified community mobilization activities in three sites to increase protective behaviours and utilization of clinical services. We compare indicators among FSW s at the beginning and after implementation. Methods We used mixed methods to collect data at three sites: in‐depth interviews (n = 22) in 2015, routine clinical data from 2010 to 2015, and two respondent driven sampling surveys in 2011 and 2015, in which participants completed an interviewer‐administered questionnaire and provided a finger prick blood sample for HIV antibody testing. Estimates were weighted using RDS ‐1 and estimate convergence assessed in both years. We assessed differences in six indicators between 2011 and 2015 using logistic regression adjusted for age, duration in sex work and education. Results 870 FSW s were recruited from the three sites in 2011 and 915 in 2015. Using logistic regression to adjust for socio‐demographic differences, we found higher estimates of the proportion of HIV ‐positive FSW s and HIV ‐positive FSW s who knew their status and reported being on ART in Mutare and Victoria Falls in 2015 compared to 2011. Reported condom use with clients did not differ by year; however, condom use with regular partners was higher in 2015 in Mutare and Hwange. Reported HIV testing in the last six months among HIV ‐negative FSW s was higher in 2015 across sites: for instance, in Victoria Falls it was 13.4% (95% CI 8.7% to 19.9%) in 2011 and 80.8% (95% CI 74.0 to 87.7) in 2015. FSW s described positive perceptions of the Sisters programme, ease of engaging with health services, and improved solidarity among peers. Programme data showed increases in service use by 2015 across all sites. Conclusions Improvements in key HIV care engagement indicators were observed among FSW s in two sites and in testing and prevention indicators across the three sites after implementation of an intensified community mobilization intervention. Engagement with services for FSW s is critical for countries to reach 90‐90‐90 targets.