Venue-Based HIV Testing at Sex Work Hotspots to Reach Adolescent Girls and Young Women Living With HIV: A Cross-sectional Study in Mombasa, Kenya

• Published in: Journal of acquired immune deficiency syndromes (1999) Vol. 84; no. 5; p. 470
• Main Authors: Ma, Huiting, Wang, Linwei, Gichangi, Peter, Mochache, Vernon, Manguro, Griffins, Musyoki, Helgar K, Bhattacharjee, Parinita, Cholette, François, Sandstrom, Paul, Becker, Marissa L, Mishra, Sharmistha
• Format: Journal Article
• Language: English
• Published: United States 15.08.2020
• Subjects: Adolescent; Cities; Cross-Sectional Studies; Female; HIV Infections - diagnosis; HIV Infections - epidemiology; HIV Testing; HIV-1; Humans; Kenya - epidemiology; Risk Factors; Sex Work; Sexual Behavior; Young Adult; Kenya; Cities
• ISSN: 1944-7884
• DOI: 10.1097/QAI.0000000000002363

We estimated the potential number of newly diagnosed HIV infections among adolescent girls and young women (AGYW) using a venue-based approach to HIV testing at sex work hotspots. We used hotspot enumeration and cross-sectional biobehavioral survey data from the 2015 Transition Study of AGYW aged 14-24 years who frequented hotspots in Mombasa, Kenya. We described the HIV cascade among young females who sell sex (YFSS) (N = 408) versus those young females who do not sell sex (YFNS) (N = 891) and triangulated the potential (100% test acceptance and accuracy) and feasible (accounting for test acceptance and sensitivity) number of AGYW that could be newly diagnosed through hotspot-based HIV rapid testing in Mombasa. We identified the profile of AGYW with an HIV in the past year using generalized linear mixed regression models. N = 37/365 (10.1%) YFSS and N = 30/828 (3.6%) YFNS were living with HIV, of whom 27.0% (N = 10/37) and 30.0% (N = 9/30) were diagnosed and aware (P = 0.79). Rapid test acceptance was 89.3%, and sensitivity was 80.4%. There were an estimated 15,635 (range: 12,172-19,097) AGYW at hotspots. The potential and feasible number of new diagnosis was 627 (310-1081), and 450 (223-776), respectively. Thus, hotspot-based testing could feasibly reduce the undiagnosed fraction from 71.6% to 20.2%. The profile of AGYW who recently tested was similar among YFSS and YFNS. YFSS were 2-fold more likely to report a recent HIV test after adjusting for other determinants [odds ratio (95% confidence interval): 2.2 (1.5 to 3.1)]. Reaching AGYW through hotspot-based HIV testing could fill gaps left by traditional, clinic-based HIV testing services.