| Autor: |
McKinnon LR; Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya. lyle.mckinnon@caprisa.org.; Department of Medicine, University of Toronto, Toronto, Canada. lyle.mckinnon@caprisa.org.; Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 2nd floor DDMRI, 719 Umbilo Road, Congella, Private Bag X7, Durban, 4013, South Africa. lyle.mckinnon@caprisa.org., Izulla P; Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya., Nagelkerke N; Community Medicine, United Arab Emirates University, Al Ain, United Arab Emirates.; Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada., Munyao J; Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya., Wanjiru T; Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya., Shaw SY; Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada., Gichuki R; Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya., Kariuki C; Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya., Muriuki F; Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya., Musyoki H; National AIDS & STI Control Programme (NASCOP), Ministry of Public Health and Sanitation, Nairobi, Kenya., Gakii G; Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya., Gelmon L; Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya.; Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada., Kaul R; Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya.; Department of Medicine, University of Toronto, Toronto, Canada.; Division of Infectious Diseases, University Health Network, University of Toronto, Toronto, Canada., Kimani J; Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya.; Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada. |
| Abstrakt: |
With two million new HIV infections annually, ongoing investigations of risk factors for HIV acquisition is critical to guide ongoing HIV prevention efforts. We conducted a prospective cohort analysis of HIV uninfected female sex workers enrolled at an HIV prevention clinic in Nairobi (n = 1640). In the initially HIV uninfected cohort (70 %), we observed 34 HIV infections during 1514 person-years of follow-up, i.e. an annual incidence of 2.2 % (95 % CI 1.6-3.1 %). In multivariable Cox Proportional Hazard analysis, HIV acquisition was associated with a shorter baseline duration of sex work (aHR 0.76, 95 % CI 0.63-0.91), minimum charge/sex act (aHR 2.74, 0.82-9.15, for low vs. intermediate; aHR 5.70, 1.96-16.59, for high vs. intermediate), N. gonorrhoeae infection (aAHR 5.89, 95 % CI 2.03-17.08), sex with casual clients during menses (aHR 6.19, 95 % CI 2.58-14.84), Depo Provera use (aHR 5.12, 95 % CI 1.98-13.22), and estimated number of annual unprotected regular partner contacts (aHR 1.004, 95 % CI 1.001-1.006). Risk profiling based on baseline predictors suggested that substantial heterogeneity in HIV risk is evident, even within a key population. These data highlight several risk factors for HIV acquisition that could help to re-focus HIV prevention messages. |
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