HIV testing, care and viral suppression among men who have sex with men and transgender individuals in Johannesburg, South Africa

被引:16
|
作者
Fearon, Elizabeth [1 ]
Tenza, Siyanda [2 ]
Mokoena, Cecilia [2 ]
Moodley, Kerushini [2 ]
Smith, Adrian D. [3 ]
Bourne, Adam [4 ]
Weatherburn, Peter [5 ]
Palanee-Phillips, Thesla [2 ]
机构
[1] London Sch Hyg & Trop Med, Dept Global Hlth & Dev, London, England
[2] Wits Reprod Hlth & HIV Inst, Johannesburg, South Africa
[3] Univ Oxford, Nuffield Dept Populat Hlth, Oxford, England
[4] La Trobe Univ, Australian Res Ctr Sex Hlth & Soc, Melbourne, Vic, Australia
[5] London Sch Hyg & Trop Med, Dept Publ Hlth Environm & Soc, London, England
来源
PLOS ONE | 2020年 / 15卷 / 06期
关键词
ANTIRETROVIRAL THERAPY; TREATMENT CASCADE; PREVENTION; HIV/AIDS; COVERAGE; NETWORK; WORKERS; TRENDS; LOAD;
D O I
10.1371/journal.pone.0234384
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Introduction Men who have sex with men and transgender individuals (MSM/TG) carry a disproportionately high burden of HIV, including in South Africa. However, there are few empirical population-representative estimates of viral suppression and the HIV care cascade including HIV testing among this population, nor of factors associated with these outcomes. Methods We conducted a respondent driven sampling (RDS) survey among 301 MSM/TG in Johannesburg in 2017. Participants gave blood samples for HIV testing and viral load. Participants self-completed a survey including sociodemographics, HIV testing history, and engagement in care. We calculated RDS-II weighted estimates of the percentage of HIV-negative MSM/TG reporting HIV testing in the previous 6 months, their testing experience and preferences. Among those HIV-positive, we estimated the percentage status-aware, on ART, and virally suppressed (<50 viral copies/ml plasma). We conducted RDS-weighted robust Poisson regression to obtain weighted prevalence ratios of factors associated with 1) HIV testing among those HIV-negative; and 2) viral suppression among those HIV-positive. Results There were 118/300 HIV-positive MSM/TG, (37.5%). Of the HIV-negative MSM/TG, 61.5% reported that they had tested for HIV in the previous 6 months, which was associated with selling sex to men (Prevalence Ratio = 1.67, 95% CI 1.36-2.05). There were 76/118 HIV-positive MSM/TG (56.5%) who reported having previously tested positive for HIV and 39/118 (30.0%) who reported current ART. There were 58/118 HIV-positive MSM/TG with viral loads <50 copies/ml plasma (46.9%). Viral suppression was associated with older age (adjusted PR = 1.03, 95% CI 1.00-1.06 for each year), neighbourhood, and having bought sex from men (adjusted PR = 1.53, 95% CI 1.12-2.08). Conclusions HIV prevalence was very high. Viral suppression among those HIV-positive was similar to the general male population in South Africa, but remains far short of national and international targets. A majority of HIV-negative MSM/TG had HIV tested in the previous 6 months, though there is room for improvement.
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页数:19
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