Antiretroviral Therapy among HIV-1 Infected Female Sex Workers in Benin: A Comparative Study with Patients from the General Population
The aim of this study conducted in Benin was to compare HIV-1 infected female sex workers (FSW) and patients from the general population (GP) to see whether there was a difference in adherence level, mortality rate and immuno-virologic response to antiretroviral therapy (ART).
Article in the World Journal of AIDS, 2011, 1, 94-99.
Fifty-three FSW and 318 patients from the GP were recruited and followed for at least one year. We compared both cohorts according to poor-adherence (taking <95% of the pills), CD4 count increase, undetectable viral load (VL; ≤50 copies/mL) and crude mortality rate.
During the first year, the proportion of FSW with poor-adherence was significantly higher than that of the GP patients and median gain in CD4 count among FSW was slightly lower. In the multivariate model, duration under ART as well as CD4 count at enrolment in the study and good-adherence were independently associated with undetectable VL. When adherence was withdrawn from this model, there was a borderline significant association between detectable VL and being a FSW (p = 0.074).
The crude mortality rate was 1.11 per 100 persons-years among the GP patients and 4.65 per 100 persons-years among FSW.
Response to ART was lower among FSW compared to GP patients, as a result of poorer adherence. Specific behavioural interventions are needed to improve adherence and response to ART among sexworkers.
(Edited author abstract)
This study shows us that in Benin, HIV+ sex workers benefit less from ARVs than other citizens living with HIV. We need to know if this is true worldwide because it has important implications for sex workers health and for prevention of HIV
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