Considerable distance to reach 90-90-90 targets among female sex workers, men who have sex with men and transgender women in Port Moresby, Papua New Guinea: findings from a cross-sectional respondent-driven sampling survey

• Published in: Sexually transmitted infections Vol. 96; no. 2; pp. 143 - 150
• Main Authors: Hakim, Avi J, Badman, Steven G, Weikum, Damian, Amos, Angelyne, Willie, Barne, Narokobi, Rebecca, Gabuzzi, Josephine, Pekon, Simon, Kupul, Martha, Hou, Parker, Aeno, Herick, Neo Boli, Ruthy, Nembari, Joshua, Ase, Sophie, Kaldor, John M, Vallely, Andrew J, Kelly-Hanku, Angela
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.03.2020; BMJ Publishing Group LTD
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; Age; AIDS; Anti-Retroviral Agents - therapeutic use; Antiretroviral drugs; Condoms - statistics & numerical data; Cross-Sectional Studies; Data collection; Depression - epidemiology; Disclosure; Discount coupons; Epidemiology; epidemiology (general); Estrenes; Female; Female sex workers; Gender identity; HIV; HIV Infections - blood; HIV Infections - diagnosis; HIV Infections - drug therapy; HIV Infections - epidemiology; hiv testing; Human immunodeficiency virus; Humans; Infections; Male; Medical tests; men who have sex with men; Papua New Guinea - epidemiology; Population; Prevalence; Sex industry; Sex Workers - statistics & numerical data; Sexual and Gender Minorities - statistics & numerical data; Sexual Behavior - statistics & numerical data; Sexually Transmitted Diseases - epidemiology; surveillance; Transgender persons; Transgender Persons - statistics & numerical data; transgender women; United Nations; Viral Load; Young Adult; Papua New Guinea; United States > US; Female sex workers; epidemiology (general); hiv; transgender women; hiv testing; surveillance; men who have sex with men
• ISSN: 1368-4973; 1472-3263
• DOI: 10.1136/sextrans-2019-053961

ObjectiveTo characterise the Joint United Nations Programme on HIV/AIDS 90-90-90 cascade among female sex workers (FSW) and men who have sex with men (MSM)/transgender women (TGW) in Port Moresby, Papua New Guinea (PNG).MethodsWe conducted respondent-driven sampling surveys among FSW and MSM/TGW in Port Moresby, PNG from June to October 2016. All participants spoke English or Tok Pisin and were aged >12 years. FSW had to be born female and sell/exchange sex with a male in the past 6 months. MSM/TGW had to be born male and have oral/anal sex with another male-born person in the past 6 months. Participants were interviewed and offered rapid HIV diagnostic and viral load testing. HIV viral suppression (VS) was defined as <1000 copies/mL.ResultsWe recruited 674 FSW and 400 MSM/TGW; HIV prevalence was 15.2% (95% CI 11.7 to 18.8) and 8.5% (95% CI 5.0 to 11.9), respectively. Among FSW living with HIV, 39.0% (95% CI 26.6 to 51.4) self-reported having been diagnosed; of them 79.6% (95% CI 62.7 to 96.5) self-reported being on antiretroviral therapy (ART), and 54.1% (95% CI 31.8 to 76.4) achieved VS. Among MSM/TGW living with HIV, 24.4% (95% CI 4.7 to 44.1) self-reported having been diagnosed; of them 43.9% (95% CI 33.6 to 54.8) self-reported being on ART, and 86.1% (95% CI 71.1 to 93.9) achieved VS.ConclusionsART use among those aware of their HIV status is encouraging. However, the generally low awareness of infection status among FSW and MSM/TGW with HIV and the low VS among FSW on ART indicate an urgent need for innovative strategies to increase testing uptake and ART adherence among these populations. Monitoring drug resistance may be warranted.