Derivation of an HIV Risk Score for African Women Who Engage in Sex Work | Zendy

Alexandra C. Willcox | Zendy; Barbra A. Richardson | Zendy; Juma Shafi | Zendy; Emmanuel Kabare | Zendy; John Kinuthia | Zendy; Walter Jaoko | Zendy; Kishorchandra Mandaliya | Zendy; Julie Overbaugh | Zendy; R. Scott McClelland | Zendy

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Derivation of an HIV Risk Score for African Women Who Engage in Sex Work

Author(s) -

Alexandra C. Willcox,

Barbra A. Richardson,

Juma Shafi,

Emmanuel Kabare,

John Kinuthia,

Walter Jaoko,

Kishorchandra Mandaliya,

Julie Overbaugh,

R. Scott McClelland

Publication year - 2021

Publication title -

aids and behavior

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 1.994

H-Index - 106

eISSN - 1573-3254

pISSN - 1090-7165

DOI - 10.1007/s10461-021-03235-7

Subject(s) - medicine , demography , incidence (geometry) , cohort , health psychology , population , public health , human immunodeficiency virus (hiv) , sex work , cohort study , gynecology , environmental health , immunology , nursing , physics , sociology , optics

No tool exists to stratify HIV risk in contemporary African female sex worker (FSW) populations. Data from a cohort of HIV-negative FSWs in Mombasa, Kenya from 2010 to 2017 were used to conduct a survival analysis assessing predictors of HIV infection. Stepwise regression was used to construct a multivariable model that formed the basis for the score. Seventeen HIV infections occurred over 1247 person-years of follow-up contributed by 670 women. Using depot medroxyprogesterone acetate (DMPA), having a curable sexually transmitted infection (STI), and being married contributed points to the score. HIV incidence was 0.85/100 person-years in a lower-risk group and 3.10/100 person-years in a higher-risk group. In a cohort with overall HIV incidence < 1.50/100 person-years, this risk score identified a subgroup of FSWs with HIV incidence > 3.00/100 person-years, which is the threshold used by the World Health Organization for initiating pre-exposure prophylaxis (PrEP). If validated in an external population, this tool could be useful for targeted PrEP promotion among higher-risk FSWs.

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