TY - JOUR
T1 - Risk Factors for HIV Acquisition in a Prospective Nairobi-Based Female Sex Worker Cohort
AU - McKinnon, Lyle R.
AU - Izulla, Preston
AU - Nagelkerke, Nico
AU - Munyao, Julius
AU - Wanjiru, Tabitha
AU - Shaw, Souradet Y.
AU - Gichuki, Richard
AU - Kariuki, Cecilia
AU - Muriuki, Festus
AU - Musyoki, Helgar
AU - Gakii, Gloria
AU - Gelmon, Lawrence
AU - Kaul, Rupert
AU - Kimani, Joshua
N1 - Publisher Copyright:
© 2015, Springer Science+Business Media New York.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - With two million new HIV infections annually, ongoing investigations of risk factors for HIV acquisition is critical to guide ongoing HIV prevention efforts. We conducted a prospective cohort analysis of HIV uninfected female sex workers enrolled at an HIV prevention clinic in Nairobi (n = 1640). In the initially HIV uninfected cohort (70 %), we observed 34 HIV infections during 1514 person-years of follow-up, i.e. an annual incidence of 2.2 % (95 % CI 1.6–3.1 %). In multivariable Cox Proportional Hazard analysis, HIV acquisition was associated with a shorter baseline duration of sex work (aHR 0.76, 95 % CI 0.63–0.91), minimum charge/sex act (aHR 2.74, 0.82–9.15, for low vs. intermediate; aHR 5.70, 1.96–16.59, for high vs. intermediate), N. gonorrhoeae infection (aAHR 5.89, 95 % CI 2.03–17.08), sex with casual clients during menses (aHR 6.19, 95 % CI 2.58–14.84), Depo Provera use (aHR 5.12, 95 % CI 1.98–13.22), and estimated number of annual unprotected regular partner contacts (aHR 1.004, 95 % CI 1.001–1.006). Risk profiling based on baseline predictors suggested that substantial heterogeneity in HIV risk is evident, even within a key population. These data highlight several risk factors for HIV acquisition that could help to re-focus HIV prevention messages.
AB - With two million new HIV infections annually, ongoing investigations of risk factors for HIV acquisition is critical to guide ongoing HIV prevention efforts. We conducted a prospective cohort analysis of HIV uninfected female sex workers enrolled at an HIV prevention clinic in Nairobi (n = 1640). In the initially HIV uninfected cohort (70 %), we observed 34 HIV infections during 1514 person-years of follow-up, i.e. an annual incidence of 2.2 % (95 % CI 1.6–3.1 %). In multivariable Cox Proportional Hazard analysis, HIV acquisition was associated with a shorter baseline duration of sex work (aHR 0.76, 95 % CI 0.63–0.91), minimum charge/sex act (aHR 2.74, 0.82–9.15, for low vs. intermediate; aHR 5.70, 1.96–16.59, for high vs. intermediate), N. gonorrhoeae infection (aAHR 5.89, 95 % CI 2.03–17.08), sex with casual clients during menses (aHR 6.19, 95 % CI 2.58–14.84), Depo Provera use (aHR 5.12, 95 % CI 1.98–13.22), and estimated number of annual unprotected regular partner contacts (aHR 1.004, 95 % CI 1.001–1.006). Risk profiling based on baseline predictors suggested that substantial heterogeneity in HIV risk is evident, even within a key population. These data highlight several risk factors for HIV acquisition that could help to re-focus HIV prevention messages.
KW - Co-factors of transmission
KW - Female sex workers
KW - HIV acquisition
KW - HIV/AIDS
KW - Prospective cohort
KW - Risk profile
UR - http://www.scopus.com/inward/record.url?scp=84944511131&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84944511131&partnerID=8YFLogxK
U2 - 10.1007/s10461-015-1118-7
DO - 10.1007/s10461-015-1118-7
M3 - Article
AN - SCOPUS:84944511131
SN - 1090-7165
VL - 19
SP - 2204
EP - 2213
JO - AIDS and Behavior
JF - AIDS and Behavior
IS - 12
ER -