Medicine and Health Sciences Commons^™

Exploring The Willingness Toward Hiv Immediate Test And Treat Among Msm In Nairobi And Its Environs: A Cross-Sectional Study., Kingori Ndungu, Peter Gichanga, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: In the test and treat initiative, high-risk populations are screened for human immunodeficiency virus (HIV) infection and start early treatment if diagnosed positive. This study explores factors associated with willingness to initiate testing and immediate treatment among men who have sex with men (MSM) in Nairobi and its environs. The study was informed by a conceptual framework combining the AIDS Risk Reduction Model (ARRM) and the Modified Social Ecological Model.

Methods: This cross-sectional exploratory study targeted MSM (aged 18–60 years) reporting active engagement in anal or oral sex with men in Nairobi and its surrounding areas. Purposive sampling was …

Strategies For Improving Mental Health And Wellbeing Used By Adults Ageing With Hiv From The Kenyan Coast: A Qualitative Exploration, Peter Mwangala, Ryan G. Wagner, Charles R. Newton, Amina Abubakar

Institute for Human Development

Background: Physical and mental health problems are common among older adults living with HIV (OALWH). Adaptive coping strategies play a vital role in improving these adults' mental health and well-being despite the deleterious effects of HIV and ageing. However, in sub-Saharan Africa, limited evidence exists on the commonly utilized coping strategies in this population. We explore the coping strategies used by Kenyan OALWH to improve their mental health and wellbeing.

Methods: Semi-structured in-depth interviews were conducted between October and December 2019 with 56 participants: 34 OALWH (53% female), 11 healthcare providers (63% female) and 11 primary caregivers (73% female) in …

Navigating Life With Hiv As An Older Adult On The Kenyan Coast: Perceived Health Challenges Seen Through The Biopsychosocial Model, Patrick Mwangala, Ryan G. Wagner, Charles Newton, Amina Abubakar

Institute for Human Development

Objectives: This study explores the perceptions of adults living with HIV aged ≥50 years (recognized as older adults living with HIV—OALWH), primary caregivers and healthcare providers on the health challenges of ageing with HIV at Kilifi, a low literacy setting on the coast of Kenya.

Methods: We utilized the biopsychosocial model to explore views from 34 OALWH and 22 stakeholders on the physical, mental, and psychosocial health challenges of ageing with HIV in Kilifi in 2019. Data were drawn from semi-structured in-depth interviews, which were audio-recorded and transcribed. A framework approach was used to synthesize the data.

Results: Symptoms of …

Prevalence Of Hiv And Associated Risk Factors Among Street-Connected Children In Mwanza City, Said Nyumayo, Eveline Konje, Benson Kidenya, Anthony Kapesa, Marko Hingi, Nyagwegwe Wango, Joshua Ngimbwa, Violeth Alphonce, Namanya Basinda

Institute for Educational Development, East Africa

While on the street, HIV infection among street-connected children is a challenging issue due to the nature of transmission, distribution, and prevention. Lack of proper care and protection, insufficient knowledge of the danger of acquiring HIV, and insufficient or absence of health facilities serving street-connected children have left this vulnerable group engaging in high-risk behaviors exposing them to acquiring HIV. This cross-sectional study aimed at estimating the prevalence of HIV infection and its associated risk factors among street-connected children aged between 10 to17 years in Mwanza City. The study was granted ethical clearance all permissions and restrictions to work with …

Measurement Characteristics And Correlates Of Hiv-Related Stigma Among Adults Living With Hiv: A Cross-Sectional Study From Coastal Kenya, Stanley W. Wanjala, Moses Nyongesa, Paul Mwangi, Agnes M. Mutua, Stanley Luchters, Charles R J C Newton, Amina Abubakar

Institute for Human Development

Objective We studied the psychometric properties of the 12-item short version of the Berger HIV stigma scale and assessed the correlates of HIV-related stigma among adults living with HIV on the Kenyan coast.

Design Cross-sectional study.

Setting Comprehensive Care and Research Centre in the Kilifi County Hospital.

Participants Adults living with HIV on combination antiretroviral therapy were recruited and interviewed between February and April 2018 (n=450).

Main outcome measures HIV-related stigma.

Results 450 participants with a median age of 43 years (IQR=36–50) took part in the study. Of these, 356 (79.1%) were female. Scale reliability and validity were high (alpha=0.80, …

Correlates Of Health-Related Quality Of Life In Primary Caregivers Of Perinatally Hiv Infected And Hiv Exposed Uninfected Adolescents At The Kenyan Coast, Patrick N. Mwangala, Derrick Ssewanyana, Paul Mwangi, Esther Chongwo, Carophine Nasambu, Vincent A. Kagonya, Gaia Scerif, Charles R. Newton, Amina Abubakar

Institute for Human Development

Background: Mothers and other primary caregivers play a crucial role in looking after perinatally HIV infected, and HIV exposed uninfected adolescents in sub-Saharan Africa. Day- to-day caregiving in the context of limited instrumen- tal support and added biomedical risk (HIV seropositivity) may expose these caregivers to adverse states of health. Unfortunately, very few studies have examined their health-related quality of life (HRQoL). Our study documents the HRQoL profile, and associated factors in primary caregivers of perinatally HIV infected, perinatally HIV exposed but uninfected and HIV unexposed/uninfected adolescents aged 12–17 years at the Kenyan Coast.

Methods: This was a …

Human Papillomavirus-Associated Anal Squamous Intraepithelial Lesions In Men Who Have Sex With Men And Transgender Women Living With And Without Hiv In Karachi Pakistan: Implications For Screening And Prevention, Muslima Ejaz, Muhammad Mubarak, Tazeen Saeed Ali, Sören Andersson, Anna Mia Ekström

Community Health Sciences

Background: Anal squamous intraepithelial lesions (ASIL), strongly related to human papilloma virus (HPV) infection, is more prevalent among men who have sex with men (MSM). However, no such data are available for Pakistan yet, and neither HPV vaccination nor anal-cytology screening is implemented in Pakistan. The purpose of this first ever study was to assess the prevalence of HPV-related anal cytological abnormalities among MSM and transgender women living with and without HIV infection in Pakistan.
Methods: We conducted a cross-sectional study from March 2016 to November 2017 at sexual health centers run by the Perwaaz Trust and the National AIDS …

Association Of Care Environment With Hiv Incidence And Death Among Orphaned, Separated, And Street-Connected Children And Adolescents In Western Kenya, Paula Braitstein, Allison Delong, David Ayuku, Mary Ott, Lukoye Atwoli, Omar Galárraga, Edwin Sang, Joseph Hogan

Internal Medicine, East Africa

Importance: In 2015, there were nearly 140 million orphaned children globally, particularly in low- and middle-income regions, and millions more for whom the street is central to their everyday lives. A total of 16.6 million children were orphaned because of deaths associated with HIV/AIDS, of whom 90% live in sub-Saharan Africa. Although most orphaned and separated children and adolescents in this region are cared for by extended family, the large number of children requiring care has produced a proliferation of institutional care. Few studies have investigated the association between care environment and physical health among orphaned and separated youths in …

Operational Experiences Associated With The Implementation Of Near Point-Of-Care Early Infant Diagnosis Of Hiv In Myanmar: A Qualitative Study, Win Lei Yee, Hla Htay, Yasmin Mohamed, Claire E. Nightingale, Htay Htay Tin, Win Thein, Latt Latt Kyaw, Win Win Yee, Moe Myat Aye, Stanley Luchters

Population Health, East Africa

Background: Timely diagnosis and early initiation of life-saving antiretroviral therapy are critical factors in preventing mortality among HIV-infected infants. However, resource-limited settings experience numerous challenges associated with centralised laboratory-based testing, including low rates of testing, complex sample referral pathways and unacceptably long turnaround times for results. Point-of-care (POC) HIV testing for HIVexposed infants can enable same-day communication of results and early treatment initiation for HIV-infected infants. However, complex operational issues and service integration can limit utility and must be well understood prior to implementation. We explored and documented the challenges and enabling factors in implementing the POC Xpert® HIV-1 …

Probabilistic Measures Of Hiv-1 Transmission In Different Hiv-1 Key Population Groups Of Larkana, Pakistan, Syed Rizwan-Ul-Hasa, Abiha Abdullah, Shakil Arshad Siddiqui, Shakil Ahmed, Sharaf Ali Shah, Fatima Mir, Syed Hani Abidi

Medical College Documents

Objective: To estimate the probability of human immunodeficiency virus (HIV)-1 transmission from different key HIV population groups using probabilistic modelling.
Methods: This study was conducted in December 2020. A probabilistic model was used to estimate the probability of HIV-1 transmission from different key HIV population groups in Larkana. Our model was run on three probabilistic assumptions: 1) each replication gave two conceivable results: 'true' or 'false'; 2) the chance of giving a 'true' result is the same for each replication; and 3) the replications are independent - 'true' in one will not impact the likelihood of 'true' in another.
Results: …

Gender Difference In Mortality Among Pulmonary Tuberculosis Hiv Co-Infected Adults Aged 15-49 Years In Kenya, Rose J. Kosgei, Steven Callens, Peter Gichangi, Marleen Temmerman, Anne-Beatrice Kihara, Gathara David, Eunice Nyaboe Omesa, Enos Masini, E. Jane Carter

Obstetrics and Gynaecology, East Africa

Setting: Kenya, 2012–2015

Objective: To explore whether there is a gender difference in all-cause mortality among smear positive pulmonary tuberculosis (PTB)/ HIV co-infected patients treated for tuberculosis (TB) between 2012 and 2015 in Kenya.

Design: Retrospective cohort of 9,026 smear-positive patients aged 15–49 years. All-cause mortality during TB treatment was the outcome of interest. Time to start of antiretroviral therapy (ART) initiation was considered as a proxy for CD4 cell count. Those who took long to start of ART were assumed to have high CD4 cell count.

Results: Of the 9,026 observations analysed, 4,567(51%) and 4,459(49%) were women and men, …

Caregiver Experience And Perceived Acceptability Of A Novel Near Point-Of-Care Early Infant Hiv Diagnostic Test Among Caregivers Enrolled In The Pmtct Program, Myanmar: A Qualitative Study, Win Lei Yee, Kyu Kyu Than, Yasmin Mohamed, Hla Htay, Htay Htay Tin, Win Thein, Latt Latt Kyaw, Win Win Yee, Moe Myat Aye, Stanley Luchters

Population Health, East Africa

Background: The majority of HIV infection among children occurs through mother-to-child transmission. HIV exposed infants are recommended to have virological testing at birth or 4–6 weeks of age but challenges with centralized laboratory-based testing in Myanmar result in low test- ing rates and delays in result communication and treatment initiation. Decentralized point- of-care (POC) testing when integrated in prevention of mother-to-child transmission of HIV (PMTCT) services, can be an alternative to increase coverage of early infant diagnosis (EID) and timely engagement in HIV treatment and care.

Aim: This paper aims to explore experiences of caregivers of HIV-exposed infants enrolled …

Effect Of Female Sex Work-Targeted Community-Based Interventions Along The Hiv Treatment Cascade In Sub-Saharan Africa: A Systematic Review Protocol, Lydia Atuhaire, Olatunji Adetokunboh, Constance Shumba, Peter S. Nyasulu

School of Nursing & Midwifery, East Africa

Introduction: Female sex workers (FSWs) are a known high-risk group that are at increased risk of HIV transmission due to exposure to multiple sexual partners and inability to negotiate safe sex attributed to challenging economic circumstances. Previous systematic reviews have examined the effectiveness of HIV interventions prioritising FSWs and have shown that targeted interventions improve access to HIV prevention and treatment services. Interventions that increase FSWs’ uptake of services are well documented; however, evidence on specific interventions aimed at improving FSWs’ continuity in HIV care along the treatment cascade is lacking. This systematic review aims to document the performance of …

Prevalence And Risk Factors Associated With Hiv/Hepatitis B And Hiv/Hepatitis C Co-Infections Among People Who Inject Drugs In Mozambique, Cynthia Semá Baltazar, Makini Boothe, Timothy Kellogg, Paulino Ricardo, Isabel Sathane, Erika Fazito, Henry F. Raymond, Marleen Temmerman, Stanley Luchters

Obstetrics and Gynaecology, East Africa

Background: There is scare information about HIV co-infections with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) among People Who Inject Drugs (PWID) in Mozambique. This information is critical to ensure the treatment necessary to decrease the progression of liver disease and the transmission of both HIV and hepatitis. We assess the prevalence of HIV, HBV and HCV co-infections as well as associated risk factors among PWID.

Methods: The first Bio-Behavioral Surveillance Survey was conducted in 2013-2014 among persons who self-reported to have ever injected drugs. Using respondent-driven sampling, PWID aged 18 years and older were recruited …

Qualitative Assessment Of South African Healthcare Worker Perspectives On An Instrument-Free Rapid Cd4 Test, Fiona Scorgie, Yasmin Mohamed, David Anderson, Suzanne M. Crowe, Stanley Luchters, Matthew F. Chersich

Population Health, East Africa

Background: Accurate measurement of CD4 cell counts remains an important tenet of clinical care for people living with HIV. We assessed an instrument-free point-of-care CD4 test (VISITECT® CD4) based on a lateral flow principle, which gives visual results after 40 min. The test involves five steps and categorises CD4 counts as above or below 350 cells/μL. As one component of a performance evaluation of the test, this qualitative study explored the views of healthcare workers in a large women and children’s hospital on the acceptability and feasibility of the test.

Methods: Perspectives on the VISITECT® CD4 test were elicited through …

Does A History Of Sexual And Physical Childhood Abuse Contribute To Hiv Infection Risk In Adulthood? A Study Among Post-Natal Women In Harare, Zimbabwe, Simukai Shamu, Patience Shamu, Christina Zarowsky, Marleen Temmerman, Tamara Shefer, Naeemah Abrahams

Obstetrics and Gynaecology, East Africa

Background: Sexual and physical abuse in childhood creates a great health burden including on mental and reproductive health. A possible link between child abuse and HIV infection has increasingly attracted attention. This paper investigated whether a history of child physical and sexual abuse is associated with HIV infection among adult women.

Methods: A cross sectional survey was conducted among 2042 postnatal women (mean age = 26y) attending six public primary health care clinics in Harare, Zimbabwe within 6 weeks post-delivery. Clinic records were reviewed for mother’s antenatal HIV status. Participants were interviewed about childhood abuse including physical or …

Feasibility Of Antiretroviral Treatment Monitoring In The Era Of Decentralized Hiv Care: A Systematic Review, Minh D. Pham, Lorena Romero, Bruce Parnell, David A. Anderson, Suzanne M. Crowe, Stanley Luchters

Population Health, East Africa

Background: Regular monitoring of HIV patients who are receiving antiretroviral therapy (ART) is required to ensure patient benefits and the long-term effectiveness and sustainability of ART programs. Prompted by WHO recommendations for expansion and decentralization of HIV treatment and care in low and middle income countries, we conducted a systematic review to assess the feasibility of treatment monitoring in these settings.

Methods: A comprehensive search strategy was developed using a combination of MeSH and free text terms relevant to HIV treatment and care, health service delivery, health service accessibility, decentralization and other relevant terms. Five electronic databases and two conference …

Epidemiology Of Hpv Genotypes Among Hiv Positive Women In Kenya: A Systematic Review And Meta-Analysis, Sonia Menon, Aibibula Wusiman, Marie Claude Boily, Mbabazi Kariisa, Hillary Mabeya, Stanley Luchters, Frode Forland, Rodolfo Rossi, Steven Callens, Davy Vanden Broeck

Population Health, East Africa

Background: There is a scarcity of data on the distribution of human papillomavirus (HPV) genotypes in the HIV positive population and in invasive cervical cancer (ICC) in Kenya. This may be different from genotypes found in abnormal cytology. Yet, with the advent of preventive HPV vaccines that target HPV 16 and 18, and the nonavalent vaccine targeting 90% of all ICC cases, such HPV genotype distribution data are indispensable for predicting the impact of vaccination and HPV screening on prevention. Even with a successful vaccination program, vaccinated women will still require screening to detect those who will develop ICC from …

Who Guidance Grounded In A Comprehensive Approach To Sexual And Reproductive Health And Human Rights: Topical Pre-Exposure Prophylaxis, Manjula Lusti-Narasimhan, Rajat Khosla, Rachel Baggaley, Marleen Temmerman, Elizabeth Mcgrory, Tim Farley

Obstetrics and Gynaecology, East Africa

Introduction: Two new microbicide products based on topical (vaginal) application of antiretroviral drugs – 1% tenofovir gel and the dapivirine ring – are currently in late-stage clinical testing, and results on their safety and effectiveness are expected to become available in early 2015. WHO guidelines on the use of topical pre-exposure prophylaxis (topical PrEP) are important in order to ensure that these new prevention products are optimally used.

Discussion: Given that these new topical PrEP products are designed to be woman initiated and will likely be delivered in reproductive health settings, it is important to ensure that the …

The Impact Of Alcohol On Hiv Prevention And Treatment For South Africans In Primary Healthcare, Michelle Schneider, Matthew Chersich, Marleen Temmerman, Olivier Degomme, Charles D. Parry

Obstetrics and Gynaecology, East Africa

Background: Antiretroviral treatment (ART) has substantially reduced morbidity and mortality for HIV patients. In South Africa, with the largest ART programme globally, attention is needed not only on the further expansion of ART coverage, but also on factors which undermine its effectiveness, such as alcohol use.

Objective: Given the decentralised approach of nurse-initiated and -sustained ART in the South African primary health sector, it is important to document key aspects of alcohol use to be conveyed to HIV-positive individuals and those at risk for HIV.

Method: This study comprised a narrative review of relevant literature.

Results: Alcohol acts through both …

High Hiv Incidence Among Persons Who Inject Drugs In Pakistan: Greater Risk With Needle Sharing And Injecting Frequently Among The Homeless., Rab Nawaz Samo, Arshad Altaf, Ajmal Agha, Omrana Pasha, Shafquat Rozi, Ashraf Memon, Saleem Azam, Meridith Blevins, Sten Vermund, Sharaf Ali Shah

Community Health Sciences

BACKGROUND:

The incidence of HIV among persons who inject drugs (PWIDU) has fallen in many nations, likely due to successes of clean needle/syringe exchange and substance abuse treatment and service programs. However in Pakistan, prevalence rates for PWID have risen dramatically. In several cities, prevalence exceeded 20% by 2009 compared to a 2003 baseline of just 0.5%. However, no cohort study of PWID has ever been conducted.

METHODS:

We enrolled a cohort of 636 HIV seronegative PWID registered with three drop-in centers that focus on risk reduction and basic social services in Karachi. Recruitment began in 2009 (March to June) …

The Contribution Of Emotional Partners To Sexual Risk Taking And Violence Among Female Sex Workers In Mombasa, Kenya: A Cohort Study, Stanley Luchters, Marlise L. Richter, Wilkister Bosire, Gill Nelson, Nzioki Kingola, Xu-Dong Zhang, Marleen Temmerman, Matthew F. Chersich

Population Health, East Africa

Objectives: To assess sexual risk-taking of female sex workers (FSWs) with emotional partners (boyfriends and husbands), compared to regular and casual clients. Experiences of violence and the degree of relationship control that FSWs have with emotional partners are also described.

Design: Cohort study with quarterly follow-up visit over 12-months.

Methods: Four hundred HIV-uninfected FSWs older than 16 years were recruited from their homes and guesthouses in Mombasa, Kenya. A structured questionnaire assessed participant characteristics and study outcomes at each visit, and women received risk-reduction counselling, male and female condoms, and HIV testing.

Results: Four or more …

Hiv-1 Autologous Antibody Neutralization Associates With Mother To Child Transmission, Elly Baan, Anthony De Ronde, Martijn Stax, Rogier W. Sanders, Stanley Luchters, Joseph Vyankandondera, Joep M. Lange, Georgios Pollakis, William A. Paxton

Population Health, East Africa

The HIV-1 characteristics associated with mother to child transmission (MTCT) are still poorly understood and if known would indicate where intervention strategies should be targeted. In contrast to horizontally infected individuals, exposed infants possess inherited antibodies (Abs) from their mother with the potential to protect against infection. We investigated the HIV-1 gp160 envelope proteins from seven transmitting mothers (TM) whose children were infected either during gestation or soon after delivery and from four non-transmitting mothers (NTM) with similar viral loads and CD4 counts. Using pseudo-typed viruses we tested gp160 envelope glycoproteins for TZM-bl infectivity, CD4 and CCR5 interactions, DC-SIGN capture …

Research Fatigue Among Injecting Drug Users In Karachi, Pakistan, Aysha Zahidie, Arshad Altaf, Adeel Ahsan, Tanzil Jamali

Community Health Sciences

Background

Karachi is the largest metropolis of Pakistan and its economic hub attracting domestic migrants for economic opportunities. It is also the epicenter of HIV epidemic in the country. Since 2004, one pilot study and four behavioral and biological surveillance rounds have been conducted in Karachi. In addition many student research projects have also focused on key risk groups including injection drug users (IDUs). As a result of this extra ordinary exposure of same kind of questions, IDUs know how to respond to high value questions related to sharing of needles or unsafe sexual practices. The purpose of the study …

Priority Interventions To Reduce Hiv Transmission In Sex Work Settings In Sub-Saharan Africa And Delivery Of These Services, Matthew F. Chersich, Stanley Luchters, Innocent Ntaganira, Antonio Gerbase, Ying-Ru Lo, Fiona Scorgie, Richard Steen

Population Health, East Africa

Introduction: Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery.

Methods: We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed) and non-indexed journals were searched for studies with quantitative study outcomes.

Results: We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for …

Effectiveness Of A Community-Based Positive Prevention Intervention For People Living With Hiv Who Are Not Receiving Antiretroviral Treatment: A Prospective Cohort Study, Avina Sarna, Stanley Luchters, Eustasius Musenge, Jerry Okal, Matthew Chersich, Waimar Tun, Sabine Mall, Nzioki Kingola, Sam Kalibala

Population Health, East Africa

Background: We report effectiveness of an HIV-prevention intervention delivered by community health workers (CHWs) in Mombasa, Kenya, to PLHIV who have not initiated or who have discontinued ART-an often difficult-to-reach population because they fall outside the ambit of health care and prevention services.

Methods: A 2-arm cohort study assessed a structured risk-reduction intervention involving at least 4 one-to-one counseling sessions and personalized support. The control group received standard prevention services. CHWs recruited treatment-naïve people living with HIV (PLHIV) or those who had previously taken antiretroviral drugs. Data were analyzed using a Propensity Score Matched (PSM)-sample to control for baseline differences …

Parallel Ngo Networks For Hiv Control: Risks And Opportunities For Ngo Contracting., Shehla Zaidi, Xaher Gul, Noureen Aleem Nishtar

Community Health Sciences

Policy measures for preventive and promotive services are increasingly reliant on contracting of NGOs. Contracting is a neo-liberal response relying on open market competition for service delivery tenders. In contracting of health services a common assumption is a monolithic NGO market. A case study of HIV control in Pakistan shows that in reality the NGO market comprises of parallel NGO networks having widely different service packages, approaches and agendas. These parallel networks had evolved over time due to vertical policy agendas. Contracting of NGOs for provision of HIV services was faced with uneven capacities and turf rivalries across both NGO …

Comparison Of Need And Supply Of Syringes For Therapeutic Injections In Pakistan, Adnan Ahmad Khan, Momina Saleem, Huma Qureshi, Rashid Jooma, Ayesha Khan

Section of Neurosurgery

Objectives: To determine the extent of shortfall in syringes by measuring the need from nationally validated sources and comparing it with position on the supply side. This was done in order to contribute to the ongoing national discussions that have focused on increasing syringe supply to curtail syringe reuse.
Methods: Using 'Injections received' data from the Pakistan Demographic Health Survey 2006-7 (N: 5429) and the National Hepatitis Survey (N: 47,043), the study estimated the number of injections received in Pakistan. We matched these against the local syringe production figures from the syringe manufacturers' association and import figures from the Federal …

Female Sex Work And International Sport Events - No Major Changes In Demand Or Supply Of Paid Sex During The 2010 Soccer World Cup: A Cross-Sectional Study, Marlise Richter, Stanley Luchters, Dudu Ndlovu, Marleen Temmerman, Matthew Francis Chersich

Population Health, East Africa

Background: Important unanswered questions remain on the impact of international sporting events on the sex industry. Speculation about increased demand and supply of sex work often generates significant attention, but also additional funding for HIV programmes. This study assessed whether changes occurred in the demand and supply of paid sex during the 2010 Soccer World Cup in South Africa.

Methods: Trained sex worker interviewers conducted face-to-face semi-structured interviews among consenting female sex workers during May-September 2010. Using bivariate analyses we compared supply, demand, sexual risk-taking, and police and health services contact pre-World Cup, to levels during the World …

Concurrent Sexual And Substance-Use Risk Behaviours Among Female Sex Workers In Kenya's Coast Province: Findings From A Behavioural Monitoring Survey, Simon Pierre Tegang, S. Abdallah, G. Emukule, Stanley Luchters, Nzioka Kingola, M. Barasa, Stephen Mucheke, P. Mwarogo

Population Health, East Africa

While many studies confirm the association between HIV, alcohol and injecting drug use by female sex workers (FSWs), little is known about their use of marijuana, khat and other substances and the association of these substances with HIV, risky sexual behaviour, and sexual violence. To better understand this association, data were analysed from a cross-sectional, behavioural survey of 297 FSWs in Mombasa, a well-known tourist destination and the second largest port in Africa and capital city of the Coast Province in Kenya. Among the FSWs, lifetime use of different substances was reported by 91% for alcohol, 71% for khat, 34% …