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Antiretroviral Therapy among HIV-1 Infected Female Sex Workers in Benin: A Comparative Study with Patients from the General Population

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DOI: 10.4236/wja.2011.13014    4,154 Downloads   8,528 Views   Citations

ABSTRACT

Objective: The aim of this study conducted in Benin was to compare HIV-1 infected female sex workers (FSW) and patients from the general population (GP) to see whether there was a difference in adherence level, mortality rate and immuno-virologic response to antiretroviral therapy (ART). Methods: Fifty-tree FSW and 318 patients from the GP were recruited and followed for at least one year. We compared both cohorts according to poor-adherence (taking <95% of the pills), CD4 count increase, undetectable viral load (VL; ≤50 copies/mL) and crude mortality rate. We constructed a multivariate regression model to assess factors associated with undetectable VL. Results: During the first year, the proportion of FSW with poor-adherence was significantly higher than that of the GP patients (19.3% versus 7.5%; p < 0.0001) and median gain in CD4 count among FSW was slightly lower (103/mm3 versus 129/mm3; p = 0.085). In the multivariate model (including CD4 at ART initiation and the sub-cohort i.e. FSW vs GP patients), duration under ART (p = 0.003) as well as CD4 count at enrolment in the study (p < 0.0001) and good-adherence (0.057) were independently associated with undetectable VL. When adherence was withdrawn from this model, there was a borderline significant association between detectable VL and being a FSW (p = 0.074). The crude mortality rate was 1.11 per 100 persons-years among the GP patients and 4.65 per 100 persons-years among FSW. Conclusion: Response to ART was lower among FSW compared to GP patients, as a result of poorer adherence. Specific behavioural interventions are needed to improve adherence and response to ART among FSW.

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Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

S. Diabaté, D. Zannou, N. Geraldo, A. Chamberland, J. Akakpo, C. Ahouada, M. Loembé, S. Anagonou, A. Labbé, M. Alary and C. Tremblay, "Antiretroviral Therapy among HIV-1 Infected Female Sex Workers in Benin: A Comparative Study with Patients from the General Population," World Journal of AIDS, Vol. 1 No. 3, 2011, pp. 94-99. doi: 10.4236/wja.2011.13014.

References

[1] UNAIDS, “UNAIDS Report on the Global AIDS Epidemic”, Geneva, UNAIDS, 2010. http://www.unaids.org/globalreport/documents/20101123_GlobalReport_full_en.pdf
[2] Z. Mukandavire and W. Garira, “Effects of Public Health Educational Campaigns and the Role of Sex Workers on the Spread of HIV/AIDS among Heterosexuals,” Theoretical Population Biology, Vol. 72, No. 3, 2007, pp. 346-365. doi:10.1016/j.tpb.2007.07.002
[3] C. M. Lowndes, M. Alary, H. Meda, C. A. Gnintoungbe, L. Mukenge-Tshibaka, C. Adjovi, et al., “Role of Core and Bridging Groups in the Transmission Dynamics of HIV and STIs in Cotonou, Benin, West Africa,” Sexually Transmitted Infections, Vol. 78, Suppl. 1, 2002, pp. S69-S77. doi:10.1136/sti.78.suppl_1.i69
[4] P. D. Ghys, M.O. Diallo, V. Ettiegne-Traore, K. Kale, O. Tawil, M. Carael, et al., “Increase in Condom Use and Decline in HIV and Sexually Transmitted Diseases among Female Sex Workers in Abidjan, C?te d’Ivoire, 1991-1998,” AIDS, Vol. 16, No. 2, 2002, pp. 251-258. doi:10.1097/00002030-200201250-00015
[5] C. M. Lowndes, M. Alary, A. C. Labbe, C. Gnintoungbe, M. Belleau, L. Mukenge, et al., “Interventions among Male Clients of Female Sex Workers in Benin, West Africa: An Essential Component of Targeted HIV Preventive Interventions,” Sexually Transmitted Infections, Vol. 83, No. 7, 2007, pp. 577-81. doi:10.1136/sti.2007.027441
[6] R. Hayes, D. Watson-Jones, C. Celum, J. van de Wijgert and J. Wasserheit, “Treatment of Sexually Transmitted Infections for HIV Prevention: End of the Road or New Beginning?” AIDS, Vol. 24, Suppl. 4, 2010, pp. S15-S26. doi:10.1097/01.aids.0000390704.35642.47
[7] UNAIDS, “AIDS Epidemic Update,” UNAIDS, Geneva, 2009. http://data.unaids.org/pub/Report/2009/jc1700_epi_update_2009_en.pdf
[8] N. Malunguza, S. Mushayabasa, C. Chiyaka and Z. Mukandavire, “Modelling the Effects of Condom Use and Antiretroviral Therapy in Controlling HIV/AIDS among Heterosexuals, Homosexuals and Bisexuals,” Computational and mathematical methods in medicine, Vol. 11, No. 3, 2010, pp. 201-22. doi:10.1080/17486700903325167
[9] Editorial, “HIV Treatment as Prevention—It Works,” Lancet, Vol. 377, No. 9779, 2011, p.1719. doi:10.1016/S0140-6736(11)60713-7
[10] N. Ford, M. Darder, T. Spelman, E. Maclean, E. Mills and A. Boulle, “Early Adherence to Antiretroviral Medication as a Predictor of Long-Term HIV Virological Suppression: Five-Year Follow Up of an Observational Cohort,” PLoS One, Vol. 5, No. 5, 2010, pp. e10460. doi:10.1371/journal.pone.0010460
[11] P. Vickerman, F. Ndowa, N. O'Farrell, R. Steen, M. Alary and S. Delany-Moretlwe, “Using mathematical modelling to estimate the impact of periodic Presumptive Treatment on the Transmission of Sexually Transmitted Infections and HIV among Female Sex Workers,” Sexually Transmitted Infections, Vol. 86, No. 3, 2010, pp. 163-168. doi:10.1136/sti.2008.034678
[12] J. van Griensven, L. de Naeyer, T. Mushi, S. Ubarijoro, D. Gashumba, C. Gazille and R. Zachariah, “High Prevalence of Lipoatrophy among Patients on Stavudine-Con- taining First-Line Antiretroviral Therapy Regimens in Rwanda,” Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol. 101, No. 8, 2007, pp. 793-798. doi:10.1016/j.trstmh.2007.02.020
[13] S. Mercier, N. F. Gueye, A. Cournil, A. Fontbonne, N. Copin, I. Ndiaye, et al., “Lipodystrophy and metabolic Disorders in HIV-1-Infected Adults on 4- to 9-Year Antiretroviral Therapy in Senegal: A Case-Control Study,” Journal of Acquired Immune Deficiency Syndrom, Vol. 51, No. 2, 2009, pp. 224-230.
[14] World Health Organisation, “Antiretroviral Therapy for HIV Infection in Adults and Adolescents. Recommadation for a Public Health approach: 2010 Revision,” WHO, Geneva, 2010. http://whqlibdoc.who.int/publications/2010/9789241599764_eng.pdf
[15] D. M. Zannou, L. Denoeud, K. Lacombe, D. Amoussou- Guenou, J. Bashi J. Akakpo, et al., “Incidence of Lipodystrophy and Metabolic Disorders in Patients Starting Non-Nucleoside Reverse Transcriptase Inhibitors in Benin,” Antiviral Therapy, Vol. 14, No. 3, 2009, pp. 371-380.
[16] O. Keiser, H. Tweya, P. Braitstein, F. Dabis, P. MacPhail and A. Boulle, “Mortality after Failure of Antiretroviral Therapy in Sub-Saharan Africa,” Tropical medicine & international health, Vol. 15, No. 2, 2010, pp. 251-258. doi:10.1111/j.1365-3156.2009.02445.x
[17] O. Keiser, H. Tweya, A. Boulle, P. Braitstein, M. Schecter and M. W. Brinkhof, “Switching to Second-Line Antiretroviral Therapy in Resource-Limited Settings: Comparison of Programmes with and without Viral Load Monitoring,” AIDS, Vol. 23, No. 14, 2009, pp. 1867-1874. doi:10.1097/QAD.0b013e32832e05b2
[18] E. J. Mills, J. B. Nachega, D. R. Bangsberg, S. Singh, B. Rachlis, P. Wu, et al., “Adherence to HAART: A Systematic Review of Developed and Developing Nation Patient-Reported Barriers and Facilitators,” PLoS Medicine, Vol. 3, No. 11, 2006, pp. e438.
[19] C. Protopopescu, F. Raffi, P. Roux, J. Reynes, P. Dellamonica, B. Spire, et al., “Factors Associated with Non-Adherence to Long-Term Highly Active Antiretroviral Therapy: A 10 Year Follow-Up Analysis with Correction for the Bias Induced by Missing Data,” The Journal of antimicrobial chemotherapy, Vol. 64, No. 3, 2009, pp. 599-606. doi:10.1093/jac/dkp232
[20] A. D. Bouhnik, M. Chesney, P. Carrieri, H. Gallais, J. Moreaum J. P. Moatti, et al., “Nonadherence among HIV-Infected Injecting Drug Users: The Impact of Social Instability,” Journal of acquired immune deficiency syndromes, Vol. 31, Suppl. 3, 2002, pp. S149-S153. doi:10.1097/00126334-200212153-00013
[21] D. Nash, M. Katyal, M. W. Brinkhof, O. Keiser, M. May R. Hughes, et al., “Long-Term Immunologic Response to Antiretroviral Therapy in Low-Income Countries: A Collaborative Analysis of Prospective Studies,” AIDS, Vol. 22, No. 17. 2008, pp. 2291-2302.
[22] P. de Beaudrap, J. F. Etard, F. N. Gueye, M. Gueye, R. Landman, P. Girard, et al., “Long-Term Efficacy and Tolerance of Efavirenz- and Nevirapine-Containing Regimens in Adult HIV Type 1 Senegalese Patients,” AIDS research and human retroviruses, Vol. 24, No. 6, 2008, pp. 753-760. doi:10.1089/aid.2007.0295
[23] S. Toure, B. Kouadio, C. Seyler, M. Traore, N. Dakoury-Dogbo, J. Duvignac, et al., “Rapid Scaling-Up of Antiretroviral Therapy in 10,000 Adults in C?te d'Ivoire: 2-Year Outcomes and Determinants,” AIDS, Vol. 22, No. 7, 2008, pp. 873-882. doi:10.1097/QAD.0b013e3282f768f8
[24] E. Nicastri, S. Leone, C. Angeletti, L. Palmisano, L. Sarmati, A. Chiesi, et al., “Sex Issues in HIV-1-Infected Persons during Highly Active Antiretroviral Therapy: A Systematic Review,” The Journal of antimicrobial chemotherapy, Vol. 60, No. 4, 2007, pp. 724-732. doi:10.1093/jac/dkm302
[25] A. Chamberland, S. Diabaté, M. Sylla, Y. S. Anagounou, N. Geraldo, D. M. Zannou, et al., “HIV-1 Primary Drug Resistance Prevalence and Transmission in Cotonou, Benin,” 5th Conference of french speeking countries on HIV/ AIDS, Casablanca, March 2010, p. 110.
[26] D. L. Hanson, C. Adje-Toure, N. Talla-Nzussouo, P. Eby, M. Y. Borget, L.Y. Kouadio, et al., “HIV Type 1 Drug Resistance in Adults Receiving Highly Active Antiretroviral Therapy in Abidjan, C?te d'Ivoire,” AIDS research and human retroviruses, Vol. 25, No. 5, 2009, pp. 489-495. doi:10.1089/aid.2008.0273

  
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