Author(s)

Souleymane Diabaté, Djimon Marcel Zannou, Nassirou Geraldo, Annie Chamberland, Jocelyn Akakpo, Carin Ahouada, Marguerite Massinga Loembé, Sévérin Anagonou, Annie Claude Labbé, Michel Alary, Cecile Tremblay

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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 When adherence was withdrawn from this model, there was a borderline significant association between detectable VL and being a FSW (p = 0.074).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.

ART, FSW, Adherence

Diabaté, S. , Zannou, D. , Geraldo, N. , Chamberland, A. , Akakpo, J. , Ahouada, C. , Loembé, M. , Anagonou, S. , Labbé, A. , Alary, M. and Tremblay, C. (2011) Antiretroviral Therapy among HIV-1 Infected Female Sex Workers in Benin: A Comparative Study with Patients from the General Population. World Journal of AIDS, 1, 94-99. doi: 10.4236/wja.2011.13014.