Project Shikamana: Community Empowerment-Based Combination HIV Prevention Significantly Impacts HIV Incidence and Care Continuum Outcomes Among Female Sex Workers in Iringa, Tanzania
Rattachement africain : us, Tanzanie, il. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
OBJECTIVE: To determine the impact of a community empowerment model of combination HIV prevention (Project Shikamana) among female sex workers (FSW) in Iringa, Tanzania. METHODS: We conducted a 2-community randomized trial. Intervention elements included the following: (1) Community-led drop-in center and mobilization activities; (2) venue-based peer education, condom distribution, and HIV testing; (3) peer service navigation; (4) provider sensitivity trainings; and (5) SMS reminders. We used time-location sampling to enroll 496 FSW and conducted a survey and blood draws to screen for HIV and assess viral load at 0 and 18 months. We conducted an intent-to-treat analysis using logistic and Poisson regression and inverse probability weighting for primary outcomes. RESULTS: The analysis included 171 HIV-positive and 216 HIV-negative FSW who completed baseline and 18-month study visits. Participants in the intervention were significantly less likely to become infected with HIV at 18-month follow-up (RR 0.38; P = 0.047), with an HIV incidence of 5.0% in the intervention vs. 10.4% control. Decreases in inconsistent condom use over time were significantly greater in the intervention (72.0%-43.6%) vs. control (68.8%-54.0%; RR 0.81, P = 0.042). At follow-up, we observed significant differences in behavioral HIV care continuum outcomes, and positive, but nonsignificant, increases in viral suppression (40.0%-50.6%) in the intervention vs. control (35.9%-47.4%). There was a strong association of between higher intervention exposure and HIV outcomes including viral suppression. CONCLUSIONS: Project Shikamana is the first trial of community empowerment-based combination prevention among FSW in Africa to show a significant reduction in HIV incidence warranting its broader implementation and evaluation.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Project Shikamana: Community Empowerment-Based Combination HIV Prevention Significantly Impacts HIV Incidence and Care Continuum Outcomes Among Female Sex Workers in Iringa, Tanzania
- Date Crossref
- 01/10/2019
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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American University Department of Sociology pays non établi dans la noticeUniversité ou école supérieure
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Muhimbili University of Health and Allied Sciences Department of Psychiatry Dar es Salaam, Tanzanie (code pays fourni par la source)Université ou école supérieure
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Johns Hopkins University pays non établi dans la noticeUniversité ou école supérieure
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University of California Department of Medicine pays non établi dans la noticeUniversité ou école supérieure
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University of Haifa pays non établi dans la noticeUniversité ou école supérieure
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Johns Hopkins Bloomberg School of Public Health Department of Health pays non établi dans la noticeUniversité ou école supérieure
Department of Sociology — American University, Department of Psychiatry — Muhimbili University of Health and Allied Sciences (Dar es Salaam, Tanzanie) et Johns Hopkins University, avec 3 autres affiliations. Pays d’affiliation : Tanzanie.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.