20th International AIDS Conference - Melbourne, Australia


THAC03 Successful HIV Prevention Strategies with Female Sex Workers
  Oral Abstract Session : Track C
Venue: Plenary 2
Time: 24.07.2014, 14:30 - 16:00
Co-Chairs: Frances M Cowan, United Kingdom
Krystal Metcalfe, Australia

14:30
THAC0301
Abstract
Powerpoint
Webcast
We have finally woken up to the need to reach sex workers comprehensively: South Africa launches the national sex worker HIV treatment and prevention programme
K. Mangold1, C. Nogoduka2, N. Mungoni3, F. Abdullah3
1EngenderHealth, SHIPP, Pretoria, South Africa, 2Family Health International 360, Pretoria, South Africa, 3SANAC, Pretoria, South Africa

14:45
THAC0302
Abstract
Powerpoint
Webcast
Are combination prevention interventions effective? The impact of combination prevention on increasing condom use among female sex workers in Central America
J. Rivas1, S. Lungo2, S. Ruether3, K. Anfinson4, A. Cabrera2, R. Firestone5
1Panamerican Social Marketing Organization PASMO, Research, Guatemala, Guatemala, 2Panamerican Social Marketing Organization PASMO, Guatemala, Guatemala, 3Population Services International, Washington DC, United States, 4Population Services International, Guatemala, Guatemala, 5Population Services International, Research, Washington DC, United States

15:00
THAC0303
Abstract
Powerpoint
Webcast
Estimating the potential impact and efficiency of pre-exposure prophylaxis for female sex workers and men who have sex with men in Bangalore, southern India
K.M. Mitchell1, F. Terris-Prestholt1, H.J. Prudden1, B.M. Ramesh2,3, R. Washington2,4, S. Isac2, S. Rajaram5, P. Vickerman6
1London School of Hygiene and Tropical Medicine, Global Health and Development, London, United Kingdom, 2Karnataka Health Promotion Trust, Bangalore, India, 3University of Manitoba, Winnipeg, Canada, 4St John's Research Institute, Bangalore, India, 5CHARME-India Project, Bangalore, India, 6University of Bristol, Bristol, United Kingdom

15:15
THAC0304
Abstract
Effectiveness of inter-personal communication activities and TV advertisements on HIV risk reduction behaviors among female sex workers (FSW) in 5 provinces of Angola: Benguela, Cunene, Huambo, Huila, and Luanda (2013)
B. Nieto-Andrade1, V.M. Pelenda1, I. Kuleba1, A.A. Jose1, B. Da Cunha1, M. Kays2
1Population Services International - Angola, Luanda, Angola, 2Population Services International - Kenya, Nairobi, Kenya

15:30
THAC0305LB
Abstract
Powerpoint
Webcast
Estimation of the HIV care cascade for female sex workers in Zimbabwe: baseline results of the SAPPH-Ire trial
F.M. Cowan1,2, C. Davey3, S. Napierala Mavedzenge4, P. Mushati2, S. Mtetwa2, T. Chiyaka2, V. Cambiano1, N. Masuka5, M. Chemhuru6, O. Mugurungi7, D. Hanisch8, K. Hatzold9, J. Busza10, A. Phillips1, J. Hargreaves3
1University College London, Research Department of Infection and Population Health, London, United Kingdom, 2Centre for Sexual Health HIV AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe, 3London School of Hygiene and Tropical Medicine, Public Health Policy, London, United Kingdom, 4RTI International, Women's Global Health Imperative, San Francisco, United States, 5Ministry of Health and Child Care, Bulawayo, Zimbabwe, 6Ministry of Health and Child Care, Gweru, Zimbabwe, 7Ministry of Health and Child Care, Harare, Zimbabwe, 8UNFPA, Harare, Zimbabwe, 9PSI Zimbabwe, Harare, Zimbabwe, 10London School of Hygiene and Tropical Medicine, London, United Kingdom

15:45
THAC0306
Webcast
Moderated discussion

Powerpoints presentations
We have finally woken up to the need to reach sex workers comprehensively: South Africa launches the national sex worker HIV treatment and prevention programme - Kerry Mangold

Are combination prevention interventions effective? The impact of combination prevention on increasing condom use among female sex workers in Central America - Jorge Rivas

Estimating the potential impact and efficiency of pre-exposure prophylaxis for female sex workers and men who have sex with men in Bangalore, southern India - Kate Margaret Mitchell

Estimation of the HIV care cascade for female sex workers in Zimbabwe: baseline results of the SAPPH-Ire trial - Frances M Cowan



Rapporteur report

Track C report by Frederick Altice


THAC0301:  K Mangold provided background for the current RSA National Strategic Plan (NSP) for HIV, STIs and TB, which finally identifies SWs as a key population, leading to launch of the South African National Sex Worker HIV Prevention and Treatment Programme (NSWP), a novel program focused on: 1) Reducing social and structural barriers to HIV, STIs and TB prevention and care; 2) Reducing the sexual transmission of HIV among SWs and sexual partners using combination prevention;  3) Sustaining health and wellness in the SW setting; and 4) Strengthening the health system for NSWP implementation.

The comprehensive minimum care package for sex worker-focused services include HIV/TB/STI, sexual and reproductive health, psychosocial and justice-related services. SW, however, remains criminalized, which is a major stumbling block to HIV prevention.

THAC0302: J Rivas presented data from 6 Central American countries from 3293 FSWs recruited using Time-location sampling.  Using a sophisticated case/control method for matching, average treatment effects for HIV testing and condom use outcomes were estimated, which revealed inter-country diversity, with FSWs in El Salvador, Panama and Costa Rica with the most impact from the combination of individual, biomedical and the structural interventions on consistent condom use with regular partners There was no impact on paying customers, in which high levels of condom use are already reported. 

THAC0303:  KM Mitchell, using a deterministic mathematical model, estimated the potential impact and efficiency of PrEP for FSWs and MSM in Bangalore, India.  Using PrEP with 40% coverage and 60% efficacy for its use, the model predicted over 10 years that PrEP could avert 23% new infections among both FSW and MSM.   PrEP among FSW, however, averted more infections across the whole population than MSM, primarily due to the secondary reductions in male paying clients.  The effects on infections averted, however, were “additive” for FSW and MSM. Not accounted for in the model was the influence on adherence due to alcohol and drug use and that FSW are migratory and leave treatment more often while MSM are likely to remain near accessible and continuous services. 

THAC0304: B Nieto-Andrade used a matching case-control study to examine the effectiveness of inter-personal communication activities and TV advertisements (e.g., condoms) on HIV risk reduction behaviors among 1,242 FSWs recruited using time-location sampling in 5 provinces of Angola. Exposure to interpersonal communication (IPC) was associated with increased HIV testing (AOR=2.1), condom use at last anal sex (AOR=1.8) and lubricant use last month (AOR=1.9). Exposure to TV-advertisements was associated with: HIV testing (AOR=1.9), lubricant use last month (AOR=2.9) and condom use at last vaginal sex (AOR=1.8;CI:1.4-2.6). FSW working in establishments reported higher likelihood of condom use at last vaginal sex compared to street-based FSW, when controlling for IPC, TV exposure and education.

THAC0305LB: FM Cowan provided empiric data from a planning study to estimate HIV care cascade for FSWs in Zimbabwe (SAPPH-Ire trial), which will be a matched-pair, cluster-randomized trial of ART for prevention among FSW in Zimbabwe conducted in 14 communities. For planning, 2,722 recruited were primarily unmarried (99%), reported starting sex work before age 18 (18%) and reported intimate partner violence (37.4%). HIV prevalence was 56% with only 61% of HIV+ FSW being diagnosed, 40% reported taking ART with 31% reporting taking ART having an undetectable VL. Some reporting bias was noted because 14% of HIV+ FSW had undetectable VL despite not reporting being on ART.




   

    The organizers reserve the right to amend the programme.