HIV prevention and treatment cascades among female sex workers in Ghana: gaps and priorities that should be addressed by the national programme

Abstract Background There is currently limited knowledge about HIV prevention and treatment cascades among female sex workers (FSW) in Ghana. This study sought to use the 2020 bio-behavioural survey (BBS) among FSWs to identify gaps and priorities in HIV treatment and prevention cascades to help ach...

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Main Authors: Samuel Dery, Chris Guure, Kwaku Owusu-Ansah, Amos Apreko, Comfort Asamoah-Adu, Stephen Ayisi Addo, Kwasi Torpey
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-024-10322-2
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author Samuel Dery
Chris Guure
Kwaku Owusu-Ansah
Amos Apreko
Comfort Asamoah-Adu
Stephen Ayisi Addo
Kwasi Torpey
author_facet Samuel Dery
Chris Guure
Kwaku Owusu-Ansah
Amos Apreko
Comfort Asamoah-Adu
Stephen Ayisi Addo
Kwasi Torpey
author_sort Samuel Dery
collection DOAJ
description Abstract Background There is currently limited knowledge about HIV prevention and treatment cascades among female sex workers (FSW) in Ghana. This study sought to use the 2020 bio-behavioural survey (BBS) among FSWs to identify gaps and priorities in HIV treatment and prevention cascades to help achieve the 95–95-95 fast track targets. Method The study used a cross-sectional design with Time Location Sampling (TLS) technique in all regions of Ghana. All eligible FSW at the selected venues and stipulated time frame were interviewed and tested for HIV onsite using the national testing algorithm. For condom use and HIV testing cascades, each step of the cascade was calculated as a percentage of all FSW. Analysis of treatment cascade was restricted to HIV positive participants and was presented using both conditional (% eligible PLHIV) and unconditional (% all PLHIV) approaches. Viral suppression level was defined as < 1000 copies/ml. Results A total of 6,773 participants took part in the behavioral interviews while 6,217 took part in the biological component which involves HIV testing. In all, 33% and 80% of all FSW do not consistently use condoms with their paying clients and non-paying partners respectively. The findings further show that 26.6% of FSW have never tested for HIV, and contrary to the HIV testing policy of every six months for FSW, 70.0% did not test for HIV 6 months preceding the survey and 40.7% of all FSW did not test for HIV 12 months preceding the survey. The conditional treatment cascade was 32%-71%-57% while the unconditional cascade was 32%-23%-49%. The study further shows 68% of the HIV positive FSW were not aware of their HIV positive status, 77% were not on treatment, while nearly 51% were not virally suppressed regardless of treatment status. Conclusion The results show that both the prevention and treatment cascades are suboptimal. Key gaps identified include low: HIV testing, viral load suppression, condom use with both paying clients and non-paying partners. There is therefore the need to scale prevention and treatment interventions particularly HIV testing, treatment initiation, consistent condoms use with both paying clients and non-paying partners to help achieve the 95–95-95 fast track targets.
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spelling doaj-art-bdc7e5f64d7a4bdba6fd2e70eefc99702025-08-20T01:59:43ZengBMCBMC Infectious Diseases1471-23342024-12-0124111210.1186/s12879-024-10322-2HIV prevention and treatment cascades among female sex workers in Ghana: gaps and priorities that should be addressed by the national programmeSamuel Dery0Chris Guure1Kwaku Owusu-Ansah2Amos Apreko3Comfort Asamoah-Adu4Stephen Ayisi Addo5Kwasi Torpey6Department of Biostatistics, School of Public Health, University of GhanaDepartment of Biostatistics, School of Public Health, University of GhanaDepartment of Biostatistics, School of Public Health, University of GhanaDepartment of Population, Family and Reproductive Health, School of Public Health, University of GhanaWest Africa Program to Combat AIDS and STI (WAPCAS)National AIDS/STI Control Programme, Ghana Health ServiceDepartment of Population, Family and Reproductive Health, School of Public Health, University of GhanaAbstract Background There is currently limited knowledge about HIV prevention and treatment cascades among female sex workers (FSW) in Ghana. This study sought to use the 2020 bio-behavioural survey (BBS) among FSWs to identify gaps and priorities in HIV treatment and prevention cascades to help achieve the 95–95-95 fast track targets. Method The study used a cross-sectional design with Time Location Sampling (TLS) technique in all regions of Ghana. All eligible FSW at the selected venues and stipulated time frame were interviewed and tested for HIV onsite using the national testing algorithm. For condom use and HIV testing cascades, each step of the cascade was calculated as a percentage of all FSW. Analysis of treatment cascade was restricted to HIV positive participants and was presented using both conditional (% eligible PLHIV) and unconditional (% all PLHIV) approaches. Viral suppression level was defined as < 1000 copies/ml. Results A total of 6,773 participants took part in the behavioral interviews while 6,217 took part in the biological component which involves HIV testing. In all, 33% and 80% of all FSW do not consistently use condoms with their paying clients and non-paying partners respectively. The findings further show that 26.6% of FSW have never tested for HIV, and contrary to the HIV testing policy of every six months for FSW, 70.0% did not test for HIV 6 months preceding the survey and 40.7% of all FSW did not test for HIV 12 months preceding the survey. The conditional treatment cascade was 32%-71%-57% while the unconditional cascade was 32%-23%-49%. The study further shows 68% of the HIV positive FSW were not aware of their HIV positive status, 77% were not on treatment, while nearly 51% were not virally suppressed regardless of treatment status. Conclusion The results show that both the prevention and treatment cascades are suboptimal. Key gaps identified include low: HIV testing, viral load suppression, condom use with both paying clients and non-paying partners. There is therefore the need to scale prevention and treatment interventions particularly HIV testing, treatment initiation, consistent condoms use with both paying clients and non-paying partners to help achieve the 95–95-95 fast track targets.https://doi.org/10.1186/s12879-024-10322-2HIVPrevention cascadeTreatment cascadeFemale sex workersGhana
spellingShingle Samuel Dery
Chris Guure
Kwaku Owusu-Ansah
Amos Apreko
Comfort Asamoah-Adu
Stephen Ayisi Addo
Kwasi Torpey
HIV prevention and treatment cascades among female sex workers in Ghana: gaps and priorities that should be addressed by the national programme
BMC Infectious Diseases
HIV
Prevention cascade
Treatment cascade
Female sex workers
Ghana
title HIV prevention and treatment cascades among female sex workers in Ghana: gaps and priorities that should be addressed by the national programme
title_full HIV prevention and treatment cascades among female sex workers in Ghana: gaps and priorities that should be addressed by the national programme
title_fullStr HIV prevention and treatment cascades among female sex workers in Ghana: gaps and priorities that should be addressed by the national programme
title_full_unstemmed HIV prevention and treatment cascades among female sex workers in Ghana: gaps and priorities that should be addressed by the national programme
title_short HIV prevention and treatment cascades among female sex workers in Ghana: gaps and priorities that should be addressed by the national programme
title_sort hiv prevention and treatment cascades among female sex workers in ghana gaps and priorities that should be addressed by the national programme
topic HIV
Prevention cascade
Treatment cascade
Female sex workers
Ghana
url https://doi.org/10.1186/s12879-024-10322-2
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