18 results on '"Matambanadzo, Primrose"'
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2. HIV prevalence, risk behaviour, and treatment and prevention cascade outcomes among cisgender men, transgender women, and transgender men who sell sex in Zimbabwe: a cross-sectional analysis of programme data
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Kloek, Mariëlle, Chabata, Sungai T, van Noord, Laura, Machingura, Fortunate, Makandwa, Rumbidzo, Dirawo, Jeffrey, Takaruza, Albert, Matambanadzo, Primrose, de Vlas, Sake J, Hontelez, Jan A C, and Cowan, Frances M
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- 2023
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3. We carried her in a wheelbarrow to the clinic”: Process evaluation of the AMETHIST intervention combining microplanning with self-help groups to improve HIV prevention and treatment among female sex workers in Zimbabwe
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Machingura, Fortunate, primary, Madimutsa, Gracious, additional, Makamba, Memory, additional, Kujeke, Tatenda, additional, Takaruza, Albert, additional, Maguma, Jaspar, additional, Ali, Sanni, additional, Chabata, Sungai T, additional, Matambanadzo, Primrose, additional, Steen, Richard, additional, Shahmanesh, Maryam, additional, Mpofu, Amon, additional, Mugurungi, Owen, additional, Phillips, Andrew N, additional, Hargreaves, James R, additional, Cowan, Frances M, additional, and Busza, Joanna, additional
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- 2024
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4. Using a Programme Science approach to substantially reduce the risk of HIV transmission and acquisition in sex transactions among female sex workers in Zimbabwe.
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Cowan, Frances M., Musemburi, Sithembile, Matambanadzo, Primrose, Chida, Phillip, Steen, Richard, Makandwa, Rumbidzo, Chabata, Sungai T., Takura, Albert, Sheets, Amber, Yekeye, Raymond, Mugurungi, Owen, Hensen, Bernadette, Busza, Joanna, and Hargreaves, James R.
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HIV infection transmission ,SEX workers ,LITERATURE reviews ,PRE-exposure prophylaxis ,HIV prevention ,YOUNG women - Abstract
Introduction: We used a Programme Science platform, to generate evidence to support the implementation of programmes for sex workers in Africa. Female sex workers are estimated to make up 1.6% (1.3%–1.8%) of the population of women aged 15−49 years in Zimbabwe. We highlight how programme science can be used to help distinguish between when, where and with whom programmes need to be implemented and discuss two case studies that exemplify implementing better (Case study 1 (1 June 2019−30 June 2021) Optimizing implementation of a risk differentiated microplanning intervention) and implementing differently (Case study 2 (1 October 2016−30 September 2022) Reorientating implementation of DREAMS for young women selling sex). Methods: Zimbabwe's nationally scaled programme for sex workers was established in 2009 in partnership with sex workers to provide comprehensive services for sex workers and generate evidence for programme design, implementation and scale up. Since inception, comprehensive data have been collected from all sex workers seeking services. As the scope of service provision has expanded so has the scope of data collection and analysis. At enrolment, sex workers are assigned an alphanumeric unique identifier which links consultations within and across programme sites. We conduct descriptive analyses of the Key Population (KP) programme data to guide programme implementation and redesign, embedding programmatic qualitative enquiry as required. Results: Two case studies describing different approaches to programme optimization are presented. In the first, an optimization exercise was used to strengthen programme implementation ensuring that the KP programme got back on track after SARS‐COV‐2. In the second, an in‐depth review of research and programme data led to a re‐orientation of the DREAMS programme to ensure that young women at the highest risk of HIV acquisition were enrolled and had access to DREAMS social support interventions in turn strengthening their uptake of HIV prevention. Conclusions: Optimizing and sustaining HIV care and treatment programmes requires effective delivery with sufficient scale and intensity for population impact. Our programme science approach guided the scale up of the KP programme in Zimbabwe, providing evidence to support strategy, implementation and ongoing management, and importantly helping us distinguish between when we needed to just implement, implement better or implement differently. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Interpreting declines in HIV test positivity: an analysis of routine data from Zimbabwe's national sex work programme, 2009–2019
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Jones, Harriet S., Hensen, Bernadette, Musemburi, Sithembile, Chinyanganya, Lilian, Takaruza, Albert, Chabata, Sungai T., Matambanadzo, Primrose, Rice, Brian, Cowan, Frances M., and Hargreaves, James R.
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Women -- Health aspects ,HIV testing -- Methods -- Information management ,Prostitutes -- Demographic aspects -- Health aspects -- Information management ,HIV infection -- Demographic aspects -- Information management ,Company systems management ,Health - Abstract
: Introduction: Early diagnosis of HIV is critical for epidemic control. To achieve this, successful testing programmes are essential and test positivity is often used as a marker of their performance. The aim of this study was to analyse trends and predictors of HIV test positivity over time and explore how an understanding of seroconversion rates could build on our interpretation of this indicator among female sex workers in Zimbabwe. Methods: We analysed HIV test data from Zimbabwe's nationally scaled sex work programme between 2009 and 2019. We defined test positivity as the proportion of all tests that were HIV positive and measured new diagnoses by estimating seroconversion rates among women with repeat tests, defined as an HIV‐positive test after at least one HIV‐negative test in the programme. We used logistic regression to analyse test positivity over three time‐periods: 2009–2013, 2014–2017 and 2018–2019, adjusting for potential confounding by demographic factors and the mediating effects of time since last HIV test. We calculated the seroconversion rates for the same time‐periods. Results: During the 10‐year study period, 54,503 tests were recorded in 39,462 women. Between 2009 and 2013, 18% of tests were among women who reported testing in the previous 6 months. By 2018–2019, this had increased to 57%. Between 2018 and 2019, test positivity was 9.6%, compared to 47.9% for 2009–2013 (aOR 6.08 95% CI 5.52–6.70) and 18.8% for 2014–2017 (aOR 2.17 95% CI 2.06–2.28). Adjusting for time since last test reduced effect estimates for 2009–2013 (aOR 4.03 95% CI 3.64–4.45) and 2014–2017 (aOR 1.97 95% CI 1.86–2.09) compared to 2018–2019. Among 7573 women with an initial HIV‐negative test in the programme and at least one subsequent test, 464 tested HIV positive at a rate of 3.9 per 100 pyar (95% CI 3.5–4.2). Conclusions: Test positivity decreased among women testing through the programme over time, while seroconversion rates remained high. These declines were partly driven by changes in individual testing history, reflecting comprehensive coverage of testing services and greater knowledge of HIV status, but not necessarily declining rates of seroconversion. Understanding testing history and monitoring new HIV infections from repeat tests could strengthen the interpretation of test positivity and provide a better understanding of programme performance., INTRODUCTION Early diagnosis of HIV is critical for epidemic control. Female sex workers (FSW) in sub‐Saharan Africa are at greater risk of HIV infection than other women of reproductive age, [...]
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- 2022
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6. Temporal Trends and Risk Factors for HIV Seroconversion Among Female Sex Workers Accessing Zimbabwe's National Sex Worker Programme: An Analysis of Routinely Collected HIV Testing Data between 2009 and 2019
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Jones, Harriet S., primary, Hensen, Bernadette, additional, Musemburi, Sithembile, additional, Chinyanganya, Lilian, additional, Takaruza, Albert, additional, Chabata, Sungai T., additional, Matambanadzo, Primrose, additional, Platt, Lucy, additional, Rice, Brian, additional, Cowan, Frances M., additional, and Hargreaves, James, additional
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- 2023
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7. HIV prevention in individuals engaged in sex work
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Busza, Joanna, primary, Matambanadzo, Primrose, additional, Phiri, Lawrence, additional, Meki, Bee, additional, and Cowan, Frances M., additional
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- 2022
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8. HIV prevention in individuals engaged in sex work.
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Busza, Joanna, Matambanadzo, Primrose, Phiri, Lawrence, Meki, Bee, and Cowan, Frances M.
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- 2023
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9. “It went through the roof”: an observation study exploring the rise in PrEP uptake among Zimbabwean female sex workers in response to adaptations during Covid‐19
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Matambanadzo, Primrose, primary, Busza, Joanna, additional, Mafaune, Haurovi, additional, Chinyanganya, Lillian, additional, Machingura, Fortunate, additional, Ncube, Getrude, additional, Steen, Richard, additional, Phillips, Andrew, additional, and Cowan, Frances Mary, additional
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- 2021
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10. Potential reduction in female sex workers' risk of contracting HIV during coronavirus disease 2019
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Machingura, Fortunate, Chabata, Sungai T, Busza, Joanna, Jamali, Gracious, Makamba, Memory, Dirawo, Jeffrey, Yekeye, Raymond, Mugurungi, Owen, Matambanadzo, Primrose, and Cowan, Frances Mary
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Female sex workers' livelihoods in Zimbabwe have been severely impacted by the coronavirus disease 2019 pandemic due to closure of entertainment venues. Competition over fewer clients has reduced ability to negotiate condom use. At the same time as partner numbers have decreased, frequency of reported condomless sex has not increased, suggesting potential reduction in overall HIV and sexually transmitted infection risk and an opportunity for programmes to reach sex workers with holistic social and economic support and prevention services.
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- 2021
11. Potential reduction in female sex workers’ risk of contracting HIV during Covid-19
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Machingura, Fortunate, Chabata, Sungai, Busza, Joanna, Jamali, Gracious, Makamba, Memory, Dirawo, Jeffrey, Yekeye, Raymond, Mugurungi, Owen, Matambanadzo, Primrose, and Cowan, Frances
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wc_140 ,wa_395 ,wc_503 ,wa_309 - Abstract
Female sex workers’ livelihoods in Zimbabwe have been severely impacted by the Covid-19 pandemic due to closure of entertainment venues. Competition over fewer clients has reduced ability to negotiate condom use. At the same time as partner numbers have decreased, frequency of reported condomless sex has not increased, suggesting potential reduction in overall HIV and STI risk and an opportunity for programmes to reach sex workers with holistic social and economic support and prevention services.
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- 2021
12. Effect of prices, distribution strategies, and marketing factors on demand for HIV self-tests in Zimbabwe: A randomized clinical trial
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Chang, Wei, Matambanadzo, Primrose, Takaruza, Albert, Hatzold, Karin, Cowan, Frances, Sibanda, Euphemia, and Thirumurthy, Harsha
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wc_503_1 ,wa_395 ,wc_503 ,41b6e438 - Abstract
Importance: HIV self-testing (HIVST) is a promising approach for increasing awareness of HIV status in sub-Saharan Africa, but evidence is lacking on optimal pricing policies and delivery strategies for maximizing the impact of HIVST.\ud Objective: Assess demand for HIV self-tests among adults and priority population subgroups under alternative pricing and distribution strategies.\ud Design: Randomized trial between February 15, 2018 and May 25, 2018. A factorial design was used to randomly assign participants to a combination of self-test price, distribution site, and promotion message. \ud Setting: Urban and rural communities in Zimbabwe\ud Participants: Individuals aged ≥16 years\ud Intervention: Participants were given a voucher enabling them to redeem an HIV self-test within 1 month at varying prices (US$0-US$3) and distribution sites (clinics or pharmacies in urban areas, retail stores or community health workers in rural areas). Vouchers included randomly assigned promotion messages that emphasized benefits of HIV testing. \ud Main Outcome and Measure: Proportion of participants who obtained self-tests in each trial arm, measured by distributor records.\ud Results: Among 4,787 individuals assessed for eligibility, 4,000 were enrolled. Participants’ average age was 35 years, 71% were female, and 66% were married. Self-test demand was highly price-sensitive; 260 participants (32.5%) offered free self-tests redeemed vouchers compared with 55 (6.9%) participants offered self-tests for US$ 0.5 (odds ratio, OR, 0.14, 95% CI 0.10-0.19), a reduction in demand of >25%. Demand was below 3% in the $1, $2, and $3 groups, significantly lower than the free distribution group. In pooled analyses, demand was considerably lower among participants in groups with price >$0 compared to the free distribution group (2.8% vs. 32.5%, OR 0.05, 95% CI 0.04-0.07). In urban areas, demand was significantly higher with pharmacy-based distribution versus clinic-based distribution (6.8% vs. 2.9%, adjusted odds ratio, 2.78, 95% CI 1.74–4.45). Price sensitivity was significantly higher among rural residents, men, and those who had never tested before. Promotion messages did not influence demand.\ud Conclusions and Relevance: Demand for HIV self-tests in Zimbabwe is highly price-sensitive. Free distribution may be essential for promoting testing among high priority population groups. Pharmacy-based distribution is preferable to clinic-based distribution in urban areas. \ud Trial Registration: NCT03559959
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- 2019
13. Effect of Prices, Distribution Strategies, and Marketing on Demand for HIV Self-testing in Zimbabwe
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Chang, Wei, primary, Matambanadzo, Primrose, additional, Takaruza, Albert, additional, Hatzold, Karin, additional, Cowan, Frances M., additional, Sibanda, Euphemia, additional, and Thirumurthy, Harsha, additional
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- 2019
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14. S05.3 Mobilization and empowerment of sex workers: can self-help groups bring about sustained change?
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Matambanadzo, Primrose, primary
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- 2019
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15. CLUSTER RANDOMISED TRIAL OF RISK-DIFFERENTIATED CARE FOR FEMALE SEX WORKERS: AMETHIST.
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Cowan, Frances M., Machingura, Fortunate, Ali, Sanni, Chabata, Sungai, Takura, Albert, Bansi-Matharu, Loveleen, Matambanadzo, Primrose, Shahmanesh, Maryam, Busza, Joanna, Steen, Richard, Yekeye, Raymond, Mpofu, Amon, Mugurungi, Owen, Phillips, Andrew, and Hargreaves, James
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- 2023
16. A risk-differentiated, community-led intervention to strengthen uptake and engagement with HIV prevention and care cascades among female sex workers in Zimbabwe (AMETHIST): a cluster randomised trial.
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Cowan FM, Machingura F, Ali MS, Chabata ST, Takaruza A, Dirawo J, Makamba M, Hove T, Bansi-Matharu L, Matambanadzo P, Shahmanesh M, Busza J, Steen R, Yekeye R, Mpofu A, Mugurungi O, Phillips AN, and Hargreaves JR
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- Humans, Female, Zimbabwe epidemiology, Adult, Young Adult, Cluster Analysis, Pre-Exposure Prophylaxis statistics & numerical data, Pre-Exposure Prophylaxis methods, HIV Infections prevention & control, HIV Infections epidemiology, HIV Infections transmission, Sex Workers statistics & numerical data
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Background: Female sex workers remain disproportionately affected by HIV. The aim of this study was to determine the effect of risk-differentiated, peer-led support for female sex workers in Zimbabwe on the risk of HIV acquisition and HIV transmission from sex among female sex workers., Methods: In this cluster randomised, open-label, controlled study, 22 clinics dedicated to female sex workers co-located in government health facilities throughout Zimbabwe were allocated (1:1, through restricted randomisation) to usual care or AMETHIST intervention. Usual care comprised HIV testing, pre-exposure prophylaxis (PrEP), referral to government antiretroviral therapy (ART) services, contraception, condoms, syndromic management of sexually transmitted infections, health education, legal advice, and peer support. AMETHIST added peer-led microplanning tailored to individuals' risk and participatory self-help groups. All cisgender women (aged >18 years) who had sold sex within the past 30 days and lived or worked within trial cluster areas were eligible. Intervention status was not masked to programme implementers but was masked to survey teams and laboratory staff. After 28 months, a respondent-driven sampling (RDS) survey was done in the female sex worker population around each clinic, which measured the primary outcome, the combined proportion of female sex workers in the surveyed population at risk of transmitting HIV (ie, were HIV positive, not virally suppressed, and not consistently using condoms) or at risk of acquiring HIV (ie, were HIV negative and not consistently using condoms or PrEP). We report prespecified analyses of the disaggregated proportions of female sex workers in the surveyed population at risk of either transmission or acquisition of HIV. Analyses were prespecified, RDS-weighted, and age-adjusted. This trial is registered with the Pan African Clinical Trials Registry, PACTR202007818077777., Findings: The AMETHIST intervention was started on May 15, 2019, and data were collected from June 1, 2019, until Dec 13, 2021. The RDS survey was done from Oct 18 to Dec 13, 2021, with 2137 women included in the usual care group (11 clusters) and 2131 in the AMETHIST intervention group (11 clusters) after excluding survey seeds (n=132) and women with missing key data (n=44). 1973 (46·2%) of the 4268 female sex workers surveyed were living with HIV; of these, 863 (93·5%; RDS-adjusted) of 931 women in the intervention group and 927 (88·8%) of 1042 in the usual care group were virologically suppressed. 287 (22·4%) of 1200 HIV-negative women in the intervention group and 194 (15·7%) of 1096 in the usual care group reported currently taking PrEP, of whom only two (0·4%) of 569 had protective tenofovir diphosphate concentrations in dried blood spots (>700 fmol/dried blood punch). There was no effect of the intervention on the primary endpoint of risk of both HIV transmission and acquisition (intervention group n=1156/2131, RDS-adjusted proportion 55·3%; usual care group n=1104/2137, RDS-adjusted proportion 52·7%; age-adjusted risk difference -0·9%, 95% CI -5·7% to 3·9%, p=0·70). For the secondary outcomes, the proportion of women living with HIV at risk of transmission was low and significantly reduced in the intervention group (n=63/931, RDS-adjusted proportion 5·8%) compared with the usual care group (103/1041, 10·4%), with an age-adjusted risk difference of -5·5% (95% CI -8·2% to -2·9%, p=0·0003). Risk of acquisition among HIV-negative women was similar in the intervention (n=1093/1200, RDS-adjusted proportion 92·1%) and the usual care group (1001/1096, 92·2%), with an age-adjusted risk difference of -0·6% (95% CI -4·6 to 3·4, p=0·74)., Interpretation: There was no overall benefit of the intervention on combined risk of transmission or acquisition. Viral load suppression in women living with HIV was high and appeared to be further improved by AMETHIST, suggesting potential for impressive uptake and adherence to ART in vulnerable and mobile populations. Sustaining treatment and reinvigorating prevention remain crucial., Funding: The Wellcome Trust and the Bill & Melinda Gates Foundation., Translations: For the Shona and Ndebele translations of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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17. The effect on HIV transmission and cost-effectiveness of programmes for female sex workers in East, Central, and Southern Africa: a modelling study.
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Bansi-Matharu L, Revill P, Taramusi I, Steen R, Chabata ST, Busza J, Mangenah C, Musemburi S, Machingura F, Desmond N, Matambanadzo P, Shahmanesh M, Yekeye R, Mugurungi O, Cowan FM, Hargreaves JR, and Phillips AN
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- Humans, Female, Africa, Southern epidemiology, Africa, Eastern epidemiology, Africa, Central epidemiology, Adult, Incidence, Program Evaluation, HIV Infections prevention & control, HIV Infections epidemiology, HIV Infections drug therapy, HIV Infections transmission, Cost-Benefit Analysis, Sex Workers statistics & numerical data
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Background: HIV prevalence and incidence has declined in East, Central, and Southern Africa (ECSA), but remains high among female sex workers (FSWs). Sex worker programmes have the potential to considerably increase access to HIV testing, prevention, and treatment. We aimed to quantify these improvements by modelling the potential effect of sex worker programmes at two different intensities on HIV incidence and key health outcomes, and assessed the programmes' potential cost-effectiveness in order to help inform HIV policy decisions., Methods: Using a model previously used to review policy decisions in ECSA, we assumed a low-intensity sex worker programme had run from 2010 until 2023; this resulted in care disadvantages among FSWs being reduced, and also increased testing, condom use, and willingness to take pre-exposure prophylaxis (PrEP). After 2023, three policy options were considered: discontinuation, continuation, and a scale-up of the programme to high-intensity, which would have a broader reach, and higher influences on condom use, antiretroviral therapy (ART) adherence, testing, and PrEP use. Outputs of the key outcomes (the percentage of FSWs who were diagnosed with HIV, on ART, and virally suppressed; the percentage of FSWs with zero condomless partners, and HIV incidence) were compared in 2030. The maximum cost for a sex worker programme to be cost-effective was calculated over a 50-year time period and in the context of 10 million adults. The cost-effectiveness analysis was conducted from a health-care perspective; costs and disability-adjusted life-years were both discounted to present US$ values at 3% per annum., Findings: Compared with continuing a low-intensity sex worker programme until 2030, discontinuation of the programme was calculated to result in a lower percentage of FSWs diagnosed (median 88·75% vs 91·37%; median difference compared to continuation of a low-intensity programme [90% range] 2·03 [-4·49 to 10·98]), a lower percentage of those diagnosed currently taking ART (86·35% vs 88·89%; 2·38 [-3·69 to 13·42]), and a lower percentage of FSWs on ART with viral suppression (87·49% vs 88·96%; 1·17 [-6·81 to 11·53]). Discontinuation of a low-intensity programme also resulted in an increase in HIV incidence among FSWs from 5·06 per 100 person-years (100 p-y; 90% range 0·52 to 22·21) to 4·05 per 100 p-y (0·21 to 21·15). Conversely, comparing a high-intensity sex worker programme until 2030 with discontinuation of the programme resulted in a higher percentage of FSWs diagnosed (median 95·81% vs 88·75; median difference compared to discontinuation [90% range] 6·36 [0·60 to 18·63]), on ART (93·93 vs 86.35%; median difference 7·13 [-0·65 to 26·48]), and with viral suppression (93·21% vs 87·49; median difference 7·13 [-0·65 to 26·48]). A high-intensity programme also resulted in HIV incidence in FSWs declining to 2·23 per 100 p-y (0·00 to 14·44), from 5·06 per 100 p-y (0·52 to 22·21) if the programme was discontinued. In the context of 10 million adults over a 50-year time period and a cost-effectiveness threshold of US$500 per disability-adjusted life-year averted, $34 million per year can be spent for a high-intensity programme to be cost-effective., Interpretation: A sex worker programme, even with low-level interventions, has a positive effect on key outputs for FSWs. A high-intensity programme has a considerably higher effect; HIV incidence among FSW and in the general population can be substantially reduced, and should be considered for implementation by policy makers., Funding: Wellcome Trust., Competing Interests: Declaration of interests LB-M and ANP have received funds paid to their institution from the Wellcome Trust for this study (grant number: 214280/Z/18/Z), the Bill & Melinda Gates Foundation, and Horizon Europe (grant number 101103140). FMC and JRH have received funds paid to their institution from the Wellcome Trust for this study. All other authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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18. Potential reduction in female sex workers' risk of contracting HIV during coronavirus disease 2019.
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Machingura F, Chabata ST, Busza J, Jamali G, Makamba M, Dirawo J, Yekeye R, Mugurungi O, Matambanadzo P, and Cowan FM
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- Condoms, Female, Humans, SARS-CoV-2, COVID-19, HIV Infections prevention & control, Sex Workers, Sexually Transmitted Diseases
- Abstract
Female sex workers' livelihoods in Zimbabwe have been severely impacted by the coronavirus disease 2019 pandemic due to closure of entertainment venues. Competition over fewer clients has reduced ability to negotiate condom use. At the same time as partner numbers have decreased, frequency of reported condomless sex has not increased, suggesting potential reduction in overall HIV and sexually transmitted infection risk and an opportunity for programmes to reach sex workers with holistic social and economic support and prevention services., (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2021
- Full Text
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