HIV incidence and risk factors for seroconversion among female sex workers and single mothers in a 10-year prospective cohort.

IF 3.1 2区医学 Q3 IMMUNOLOGY

AIDS Pub Date : 2026-04-01 Epub Date: 2025-11-07 DOI:10.1097/QAD.0000000000004403

Kalonde Malama, Rachel Parker, Kristin M Wall, William Kilembe, Chishiba Kabengele, Sepo Mwangelwa, Tyronza Sharkey, Mubiana Inambao, Vernon Musale, Constance Himukumbwa, Matt A Price, Eric Hunter, Susan Allen

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引用次数: 0

Abstract

Objective: To compare HIV incidence among female sex workers (FSW) and single mothers, and to determine the factors associated with seroconversion among both populations.

Design: Prospective cohort conducted in Lusaka and Ndola, Zambia between 2012 and 2022.

Methods: Study staff recruited FSW from common sex work locales and recruited single mothers from postnatal infant vaccination clinics. Enrolled participants were HIV-negative, aged 18-45, and identified as either a FSW or single mother. We measured HIV incidence and assessed associated factors using Poisson regression with adjusted rate ratios (aRRs) and 95% confidence intervals (CIs).

Results: The study enrolled 2539 women (1533 FSW and 1006 single mothers). HIV incidence was not statistically different for FSW (3.24 per 100 person-years; 95% CI: 2.63-3.95) and single mothers (2.64 per 100 person-years; 95% CI: 2.00-3.43). Factors associated with HIV seroconversion were positive syphilis (aRR: 2.03; 95% CI: 1.46-2.83) and trichomonas (aRR: 1.48; 95% CI: 1.06-2.06) diagnoses, inconsistent condom use (aRR: 1.60; 95% CI: 1.06-2.40), and greater than 6months follow-up time in the study (aRR: 2.45; 95% CI: 1.52-3.94).

Conclusions: Single mothers share similar HIV risk to FSW, and both populations require targeted interventions. For single mothers, government postnatal clinics should combine comprehensive sexual education with screening and treatment for syphilis and trichomoniasis. For FSW, we recommend integrated and accessible interventions to prevent HIV and sexually transmitted infections. Future studies should investigate the social determinants of condom use among both FSW and single mothers.

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在一项10年前瞻性队列研究中，女性性工作者和单身母亲的HIV发病率和血清转化的危险因素

目的：比较女性性工作者（FSW）和单身母亲的HIV感染率，并确定两者血清转化的相关因素。设计：2012年至2022年在赞比亚卢萨卡和恩多拉进行的前瞻性队列研究。方法：研究人员从常见的性工作场所招募FSW，并从产后婴儿疫苗接种诊所招募单身母亲。被招募的参与者为艾滋病毒阴性，年龄在18-45岁之间，被确定为FSW或单身母亲。我们测量了艾滋病毒的发病率，并使用泊松回归与调整率比（aRRs）和95%置信区间（CIs）评估了相关因素。结果：该研究招募了2539名女性（1533名女职工和1006名单身母亲）。FSW（3.24 / 100人-年；95%CI:2.63-3.95）和单亲母亲（2.64 / 100人-年；95%CI:2.00-3.43）的HIV感染率无统计学差异。与HIV血清转化相关的因素为梅毒（aRR:2.03;95%CI:1.46-2.83）和滴虫（aRR:1.48;95%CI:1.06-2.06）诊断阳性、不一致的安全套使用（aRR:1.60;95%CI:1.06-2.40）以及研究中超过6个月的随访时间（aRR:2.45;95%CI:1.52-3.94）。结论：单身母亲与女性性工作者具有相似的艾滋病毒风险，这两个人群都需要有针对性的干预措施。对于单身母亲，政府产后诊所应将全面的性教育与梅毒和滴虫病的筛查和治疗结合起来。对于女性性工作者，我们建议采取综合和可获得的干预措施，以预防艾滋病毒和性传播感染。未来的研究应该调查女性性工作者和单身母亲使用避孕套的社会决定因素。

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来源期刊

AIDS 医学-病毒学

CiteScore

5.90

自引率

5.30%

发文量

478

审稿时长

3 months

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