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HIV pre-exposure prophylaxis uptake, retention and adherence among female sex workers in sub-Saharan Africa: a systematic review.
Mpirirwe, Ruth; Segawa, Ivan; Ojiambo, Kevin Ouma; Kamacooko, Onesmus; Nangendo, Joanita; Semitala, Fred C; Kyambadde, Peter; Kalyango, Joan N; Kiragga, Agnes; Karamagi, Charles; Katahoire, Anne; Kamya, Moses; Mujugira, Andrew.
Afiliación
  • Mpirirwe R; Clinical Epidemiology, Makerere University College of Health Sciences, Kampala, Uganda ruthmpirirwe@gmail.com.
  • Segawa I; Clinical Epidemiology, Makerere University College of Health Sciences, Kampala, Uganda.
  • Ojiambo KO; Clinical Epidemiology Unit, Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
  • Kamacooko O; Africa Center for Systematic Reviews and Knowledge Translation, College of Health Sciences, Makerere University, Kampala, Uganda.
  • Nangendo J; College of Health Sciences, Makerere University, Kampala, Uganda.
  • Semitala FC; Makerere University, Kampala, Uganda.
  • Kyambadde P; Infectious Diseases Research Collaboration, Kampala, Uganda.
  • Kalyango JN; Republic of Uganda Ministry of Health, Kampala, Uganda.
  • Kiragga A; Clinical Epidemiology, Makerere University College of Health Sciences, Kampala, Uganda.
  • Karamagi C; Infectious Diseases Institute, Makerere University, Kampala, Uganda.
  • Katahoire A; Clinical Epidemiology Unit, Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
  • Kamya M; College of Health Sciences, Makerere University, Kampala, Uganda.
  • Mujugira A; Makerere University, Kampala, Uganda.
BMJ Open ; 14(4): e076545, 2024 Apr 25.
Article en En | MEDLINE | ID: mdl-38670600
ABSTRACT

OBJECTIVE:

To evaluate oral pre-exposure prophylaxis (PrEP) uptake, retention and adherence among female sex workers (FSWs) receiving care through community and facility delivery models in sub-Saharan Africa (SSA).

DESIGN:

Systematic review and meta-analysis. DATA SOURCES We searched online databases (PubMed, MEDLINE, SCOPUS, EMBASE, Google Scholar, Cochrane Database of Systematic Reviews and Web of Science) between January 2012 and 3 April 2022. ELIGIBILITY CRITERIA FOR STUDIES Randomised controlled trials, cohort studies, cross-sectional studies and quasi-experimental studies with PrEP uptake, adherence and retention outcomes among FSWs in SSA. DATA EXTRACTION AND

SYNTHESIS:

Seven coders extracted data. The framework of the Cochrane Consumers and Communication Review Group guided data synthesis. The Risk of Bias In Non-Randomized Studies of Interventions tool was used to evaluate the risk of bias. Meta-analysis was conducted using a random-effects model. A narrative synthesis was performed to analyse the primary outcomes of PrEP uptake, adherence and retention.

RESULTS:

Of 8538 records evaluated, 23 studies with 40 669 FSWs were included in this analysis. The pooled proportion of FSWs initiating PrEP was 70% (95% CI 56% to 85%) in studies that reported on facility-based models and 49% (95% CI 10% to 87%) in community-based models. At 6 months, the pooled proportion of FSWs retained was 66% (95% CI 15% to 100%) for facility-based models and 83% (95% CI 75% to 91%) for community-based models. Factors associated with increased PrEP uptake were visiting a sex worker programme (adjusted OR (aOR) 2.92; 95% CI 1.91 to 4.46), having ≥10 clients per day (aOR 1.71; 95% CI 1.06 to 2.76) and lack of access to free healthcare in government-run health clinics (relative risk 1.16; 95% CI 1.06 to 1.26).

CONCLUSIONS:

A hybrid approach incorporating both facility-based strategies for increasing uptake and community-based strategies for improving retention and adherence may effectively improve PrEP coverage among FSWs. PROSPERO REGISTRATION NUMBER CRD42020219363.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Cumplimiento de la Medicación / Trabajadores Sexuales / Profilaxis Pre-Exposición Límite: Female / Humans País/Región como asunto: Africa Idioma: En Revista: BMJ Open Año: 2024 Tipo del documento: Article País de afiliación: Uganda Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Cumplimiento de la Medicación / Trabajadores Sexuales / Profilaxis Pre-Exposición Límite: Female / Humans País/Región como asunto: Africa Idioma: En Revista: BMJ Open Año: 2024 Tipo del documento: Article País de afiliación: Uganda Pais de publicación: Reino Unido