Factors associated with viral load testing and viral suppression among HIV-positive female sex workers in Nigeria

Article Article scientifique Article Factors associated with viral load testing and viral suppression among HIV-positive female sex workers in Nigeria eng 2024-05-31 2024 author Nwosu Kenechukwu 0000-0002-3245-4109 Institute of Global Health, University of Geneva, Geneva, Switzerland. 896903 Institut de santé globale (COSPR) author Kalaiwo Dr Abiye Sylvester Institute of Global Health, University of Geneva, Geneva, Switzerland.,Office of HIV/AIDS and TB, US Agency for International Development, Abuja, Nigeria. 956473 author Ngambi Wingston Felix Institute of Global Health, University of Geneva, Geneva, Switzerland.,Department of Health Systems and Policy, Health Economics and Policy Unit, Kamuzu University of Health Sciences, Lilongwe, Malawi. author Estill Janne Anton Markus Institute of Global Health, University of Geneva, Geneva, Switzerland. 873331 Institut de santé globale (COSPR) author Omo-Emmanuel Ughweroghene Kingston 0000-0003-3546-2478 Office of HIV/AIDS and TB, US Agency for International Development (USAID), Abuja, Nigeria. author Emmanuel Godwin Heartland Alliance Nigeria, Abuja, Nigeria. author Keiser Olivia 0000-0001-8191-2789 Institute of Global Health, University of Geneva, Geneva, Switzerland. 873427 Institut de santé globale (COSPR) e0304487 10.1371/journal.pone.0304487 38820395 1932-6203 PMC11142602 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0304487 Background: Female sex workers (FSWs) are at high risk for HIV infection and face unique barriers to receiving and adhering to testing and treatment. Early viral suppression and consistent viral load testing are critical to optimizing health and reducing transmission in this population. However, the factors associated with testing and successful viral suppression among FSWs are poorly understood, especially in Sub-Saharan Africa. Our study aimed to examine factors, including social, demographic, and clinical characteristics, associated with viral load testing and suppression among female sex workers initiating antiretroviral therapy in Nigeria. Methods: In this retrospective study, we analyzed routine programmatic data from FSWs enrolled in the National HIV Key Populations (KP) program in Nigeria. We included FSWs who were newly diagnosed with HIV and registered between January 2016 and January 2022. Primary outcomes of interest were a), receiving a viral load test at any point after treatment initiation and b), viral suppression (<1000 copies/ml) at the test closest to 6 months after treatment initiation. To identify factors associated with the outcomes of interest, we used univariable and multivariable logistic regression, with random intercepts for care facilities, and multiple imputation for missing values. Findings: Out of 34,976 FSWs, 97.1% (n = 33,945) received at least one viral load test, with 94.5% (n = 32,092) indicating viral suppression. The odds of receiving at least one viral load test were higher for those who entered treatment in more recent years, those with formal education and those with advanced HIV stages at baseline (adjusted odds ratios [aOR]: 1.17 [1.14-1.19] for those who entered treatment in 2020 vs. 2016; 1.02 [1.01-1.03] for post-secondary vs. no education; and 1.05 [1.01-1.10] for WHO clinical stage 3/4 vs. stage 1 respectively). The odds of successful viral suppression were higher for those who entered treatment in more recent years, but lower for those with advanced HIV stages at baseline (aOR: 1.13 [1.09-1.18] for 2022 vs. 2016; and 0.92 [0.87-0.98] for WHO clinical stage 3/4 vs. stage 1 respectively). Conclusions: The study underscored the relevance of timely diagnosis and ART initiation for optimal outcomes among HIV-positive FSWs in Nigeria. We also observed significant improvements in the likelihood of early viral load testing and suppression over the study period, reflecting advancements in the KP program. Further research should clarify factors driving these trends to further strengthen the HIV care pipeline for female sex workers. Humans Female Viral Load Nigeria / epidemiology Sex Workers / statistics & numerical data Adult HIV Infections / drug therapy HIV Infections / virology HIV Infections / epidemiology HIV Infections / diagnosis Retrospective Studies Young Adult Adolescent Anti-HIV Agents / therapeutic use Middle Aged Dewey 613 Swiss National Science Foundation Understanding the HIV epidemic in Malawi: integrating quantitative and qualitative data in a mathematical model 163878 CH Swiss National Science Foundation HIV seroconversion and HIV treatment outcomes along the cascade of care in female sex workers in Nigeria 192452 CH 66 Institut de santé globale 22A1 false 1246 Maladies infectieuses et modèles mathématiques 988 https://zenodo.org/records/8381521 PloS one 19 5 0b78b64c-fe41-474a-b6e4-19bc8330e638 Article (Published version) Public Article_scientifique_from_europePmc.pdf 2658539 application/pdf CC BY-4.0 a4d62b33a1a6f5c1f40967fdf8421d47f44b0797f0372375a09f5e9861b58025 77db7654-818c-4b40-91d0-850550edf67e Appendix Public pone.0304487.s001.xlsx 44196 application/vnd.openxmlformats-officedocument.spreadsheetml.sheet adc5c4122a0ce14b3f435f764f64c2abef1c6ffbf41cbb0a2af3f16d2bcc24cc openAccess Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires / Institut de santé globale

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Factors associated with viral load testing and viral suppression among HIV-positive female sex workers in Nigeria	PloS one	2024	10	29
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