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
{"title":"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","authors":"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","doi":"10.1097/QAD.0000000000004403","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To compare HIV incidence among female sex workers (FSW) and single mothers, and to determine the factors associated with seroconversion among both populations.</p><p><strong>Design: </strong>Prospective cohort conducted in Lusaka and Ndola, Zambia between 2012 and 2022.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"496-502"},"PeriodicalIF":3.1000,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"HIV incidence and risk factors for seroconversion among female sex workers and single mothers in a 10-year prospective cohort.\",\"authors\":\"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\",\"doi\":\"10.1097/QAD.0000000000004403\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To compare HIV incidence among female sex workers (FSW) and single mothers, and to determine the factors associated with seroconversion among both populations.</p><p><strong>Design: </strong>Prospective cohort conducted in Lusaka and Ndola, Zambia between 2012 and 2022.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":7502,\"journal\":{\"name\":\"AIDS\",\"volume\":\" \",\"pages\":\"496-502\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2026-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"AIDS\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/QAD.0000000000004403\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/11/7 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"AIDS","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/QAD.0000000000004403","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/11/7 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
HIV incidence and risk factors for seroconversion among female sex workers and single mothers in a 10-year prospective cohort.
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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Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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