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AIDS Behav. 2019 Jun 13. doi: 10.1007/s10461-019-02549-x. [Epub ahead of print]

Community-Based Antiretroviral Therapy (ART) Delivery for Female Sex Workers in Tanzania: 6-Month ART Initiation and Adherence.

Author information

1
HIV and AIDS Program, Population Council, Washington, DC, USA. wtun@popcouncil.org.
2
HIV and AIDS Program, Population Council, 4301 Connecticut Avenue, NW, Suite 280, Washington, DC, 20008, USA. wtun@popcouncil.org.
3
HIV and AIDS Program, Population Council, Dar Es Salaam, Tanzania.
4
Jhpiego, Dar Es Salaam, Tanzania.
5
Jhpiego, Njombe, Tanzania.
6
National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania.
7
National AIDS Control Programme (NACP), Ministry of Health, Community Development, Gender, Elderly and Children, Dar Es Salaam, Tanzania.
8
United States Agency for International Development (USAID), Dar Es Salaam, Tanzania.
9
HIV and AIDS Program, Population Council, Washington, DC, USA.

Abstract

We conducted an implementation science study of a community-based ART distribution program for HIV-positive female sex workers (FSW) whereby clients received ART services through community-based mobile and home-based platforms. We compared 6-month treatment-related outcomes in the community-based ART arm (N = 256) to the standard facility-based ART delivery arm (N = 253). Those in the intervention arm were more likely to have initiated ART (100.0% vs. 71.5%; p = 0.04), be currently taking ART at the 6-month visit (100.0% vs. 95.0%; p < 0.01), and less likely to have stopped taking ART for more than 30 days continuously (0.9% vs. 5.7%; p = 0.008) or feel high levels of internalized stigma (26.6% vs. 39.9%; p = 0.001). In the adjusted regression model, internalized stigma (adjusted OR [aOR]: 0.5; 95% CI 0.28-0.83) and receiving community-based ART (aOR: 208.6; 95% CI 12.5-3479.0) were significantly associated with ART initiation. Community-based ART distribution model can improve linkage to and adherence to ART over standard facility-based ART programs for FSWs.

KEYWORDS:

ART initiation; Adherence; Community-based ART; Female sex workers (FSW); Tanzania

PMID:
31197700
DOI:
10.1007/s10461-019-02549-x

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