Antiretroviral Treatment Sharing among Female sex Workers Living with HIV in eThekwini (Durban), South Africa: Drivers and Implications for Treatment Success

• Published in: Journal of the International Association of Providers of AIDS Care Vol. 21; p. 23259582221110820
• Main Authors: Rock, Amelia, Comins, Carly, Mulumba, Ntambue, Young, Katherine, Mcingana, Mfezi, Guddera, Vijayanand, Hausler, Harry, Phetlhu, Rene, Baral, Stefan, Schwartz, Sheree
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2022; SAGE PUBLICATIONS, INC; SAGE Publishing
• Subjects: Antiretroviral therapy; Drug abuse; HIV; Human immunodeficiency virus; Medical treatment; Original; Peer relationships; Prescription drugs; Prostitution; Qualitative research; Sex crimes; Sex workers; Sharing; Substance abuse; anti-retroviral therapy; south africa; drug diversion; HIV; sex work
• ISSN: 2325-9582; 2325-9574; 2325-9582
• DOI: 10.1177/23259582221110820

In South Africa, 62% of female sex workers (FSW) are estimated to be living with HIV. Qualitative research indicates that FSW share antiretroviral therapy (ART) with peers to surmount treatment barriers. We quantitatively described ART sharing, its correlates, and its relationship with viral suppression (VS) among FSW living with HIV in eThekwini, South Africa. Among FSW on ART (n = 890), 30% ever shared (gave and/or received) ART. Sharing ART was more likely among those with higher levels of alcohol use, illicit drug use, depression severity, and physical/sexual violence in the adjusted model. There was a positive, dose-response relationship between number of pills given to peers in the last 30 days and VS likelihood (aPR: 1.05, 95% CI: 1.02, 1.08; p < 0.01). Giving pills may strengthen peer relationships, which may facilitate ART adherence. ART distribution through peer networks holds promise as a context-appropriate intervention for improving ART adherence among FSW in this setting.