Huiting Ma 1, Linwei Wang 1, Peter Gichangi 2 3, Vernon Mochache 4, Griffins Manguro 3, Helgar K Musyoki 5, Parinita Bhattacharjee 6 7, François Cholette 8 9, Paul Sandstrom 8 9, Marissa L Becker 7, Sharmistha Mishra 1 10 11 12; Transitions Study Team
Affiliations
- 1MAP-Centre for Urban Health Solution, St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada.
- 2Department of Human Anatomy, University of Nairobi, Nairobi, Kenya.
- 3International Centre for Reproductive Health-Kenya, Mombasa, Kenya.
- 4University of Maryland, Centre for International Health, Education and Biosecurity, College Park, MA.
- 5National AIDS & STI Control Programme, Nairobi, Kenya.
- 6Key Populations Technical Support Unit, Partners for Health and Development in Africa, Nairobi, Kenya.
- 7Centre for Global Public Health, University of Manitoba, Winnipeg, Canada.
- 8National HIV and Retrovirology Laboratory, JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Canada.
- 9Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada.
- 10Department of Medicine, University of Toronto, Toronto, Canada.
- 11Institute of Medical Science, University of Toronto, Toronto, Canada; and.
- 12Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.
PMID: 32692105 PMCID: PMC7340222
DOI: 10.1097/QAI.0000000000002363
Abstract
Background: We estimated the potential number of newly diagnosed HIV infections among adolescent girls and young women (AGYW) using a venue-based approach to HIV testing at sex work hotspots.
Methods: We used hotspot enumeration and cross-sectional biobehavioral survey data from the 2015 Transition Study of AGYW aged 14-24 years who frequented hotspots in Mombasa, Kenya. We described the HIV cascade among young females who sell sex (YFSS) (N = 408) versus those young females who do not sell sex (YFNS) (N = 891) and triangulated the potential (100% test acceptance and accuracy) and feasible (accounting for test acceptance and sensitivity) number of AGYW that could be newly diagnosed through hotspot-based HIV rapid testing in Mombasa. We identified the profile of AGYW with an HIV in the past year using generalized linear mixed regression models.
Results: N = 37/365 (10.1%) YFSS and N = 30/828 (3.6%) YFNS were living with HIV, of whom 27.0% (N = 10/37) and 30.0% (N = 9/30) were diagnosed and aware (P = 0.79). Rapid test acceptance was 89.3%, and sensitivity was 80.4%. There were an estimated 15,635 (range: 12,172-19,097) AGYW at hotspots. The potential and feasible number of new diagnosis was 627 (310-1081), and 450 (223-776), respectively. Thus, hotspot-based testing could feasibly reduce the undiagnosed fraction from 71.6% to 20.2%. The profile of AGYW who recently tested was similar among YFSS and YFNS. YFSS were 2-fold more likely to report a recent HIV test after adjusting for other determinants [odds ratio (95% confidence interval): 2.2 (1.5 to 3.1)].
Conclusion: Reaching AGYW through hotspot-based HIV testing could fill gaps left by traditional, clinic-based HIV testing services.
Conflict of interest statement
The authors have no funding or conflicts of interest to disclose.
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