Association between Age and HIV seroconversion in Female Sex Workers and Single Mothers in Zambia Restricted; Files Only

Fisher, Anna (Spring 2024)

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The aim of the study was to assess age as an exposure to HIV seroconversion and to contribute to understanding differences in AGYW and women aged 25-49 in HIV and STI-related prevalence, demographics, and risk factors. The Center for Family Health Research in Zambia (CFHRZ) has followed cohorts of high-risk women in urban Zambia for over 20 years, including female sex workers (FSWs) for 4 years beginning in 2012, then single mothers (SMs) for 2 years starting in 2014, and finally in a combined cohort that followed both groups of high-risk women from 2017 to 2021. This report considers the baseline data for demographics and HIV risk factors and quarterly STI and HIV results for 2,660 FSWs and SMs. Over a total of 5,116 person-time years, 153 women seroconverted. FSWs contributed 2,996 years of person time and 97 seroconversions to the combined studies for an overall rate of 3.24/100PY. Out of 1,062 SMs, 56 seroconverted over 2,120 person years. Their overall rate was 2.64/100PY. Demographics and risk factors were studied as intermediates for age and seroconversion, and from the potential intermediates we analyzed, the only common intermediates for both FSWs and SMs were chlamydia, gonorrhea, and literacy. Other intermediates for FSWs were education and syphilis, and for SMs, there were no other intermediates. We hypothesize there are many other factors that we did not have data on which could be potential intermediates including changing HIV risk perception as women age. Our data does not show that beyond the age of 24 women both FSWs and SMs are rarely seroconverting. Thus, if clinical trials only enroll in the 15-24 age group, vulnerable groups of women are missing out on a potentially lifesaving treatment. Since there are significant differences among FSWs and SMs, and there are significant differences in age, programs should be tailored to each of the populations they serve.

Table of Contents

Title Page: 5

Introduction: 6-7

Methods: 8-10

Results: 10-13

Discussion: 13-16

Tables and Figures: 17-28

References: 29-30

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