HIV prevalence and incidence in a cohort of South African men and transgender women who have sex with men: the Sibanye methods for prevention packages programme (MP3) project

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dc.contributor.author Sullivan, Patrick S.
dc.contributor.author Phaswana-Mafuya, Nancy
dc.contributor.author Baral, Stefan D.
dc.contributor.author Valencia, Rachel
dc.contributor.author Zahn, Ryan
dc.contributor.author Dominguez, Karen
dc.contributor.author Yah, Clarence S.
dc.contributor.author Jones, Jeb
dc.contributor.author Kgatitswe, Lesego B.
dc.contributor.author McNaghten, A.D.
dc.contributor.author Siegler, Aaron J.
dc.contributor.author Sanchez, Travis H.
dc.contributor.author Bekker, Linda-Gail
dc.date.accessioned 2021-03-01T07:27:22Z
dc.date.available 2021-03-01T07:27:22Z
dc.date.issued 2020-10
dc.description.abstract INTRODUCTION: Men who have sex with men (MSM) and transgender women (TGW) are at increased risk for acquiring HIV, but there are limited HIV incidence data for these key populations in Africa. Understanding HIV prevalence and incidence provides important context for designing HIV prevention strategies, including pre-exposure prophylaxis (PrEP) programmes. We describe HIV prevalence, awareness of HIV infection, HIV incidence and associated factors for a cohort of MSM and TGW in Cape Town and Port Elizabeth, South Africa. METHODS: From 2015 to 2016, MSM and TGW in Cape Town and Port Elizabeth were enrolled and prospectively followed for 12 months, receiving a comprehensive package of HIV prevention services. HIV testing was conducted at baseline and at follow-up visits (targeted for three, six and twelve months). All HIV-negative PrEP-eligible participants were offered PrEP enrolment during the first four months of study participation. We determined HIV prevalence among participants at baseline, and incidence by repeat screening of initially HIV-negative participants with HIV tests at three, six and twelve months. RESULTS: Among 292 participants enrolled, HIV prevalence was high (43%; 95% CI: 38 to 49) and awareness of HIV status was low (50%). The 167 HIV-negative participants who were followed prospectively for 144.7 person-years; nine incident HIV infections were documented. Overall annual incidence was 6.2% (CI: 2.8 to 11.8) and did not differ by city. Annual HIV incidence was significantly higher for younger (18 to 19 years) MSM and TGW (MSM: 21.8% (CI: 1.2 to 100); TGW: 31.0 (CI: 3.7, 111.2)). About half of participants started PrEP during the study; the annual incidence of HIV among 82 (49%) PrEP starters was 3.6% (CI: 0.4, 13.1) and among those who did not start PrEP was 7.8% (CI: 3.1, 16.1). CONCLUSIONS: HIV incidence was high among MSM and TGW in the context of receiving a comprehensive package of prevention interventions and offering of PrEP. PrEP uptake was high; the observed incidence of HIV in those who started PrEP was about half the incidence of HIV in those who did not. Future implementation-oriented studies should focus on decisions to start and continue PrEP for those at highest risk, including young MSM. en_ZA
dc.description.department School of Health Systems and Public Health (SHSPH) en_ZA
dc.description.librarian pm2021 en_ZA
dc.description.sponsorship Center for AIDS Research at Emory University and National Institute for Allergy and Infectious Diseases. en_ZA
dc.description.uri https://onlinelibrary.wiley.com/journal/17582652 en_ZA
dc.identifier.citation Sullivan, P.S., Phaswana-Mafuya, N., Baral, S.D. et al. 2020, 'HIV prevalence and incidence in a cohort of South African men and transgender women who have sex with men: the Sibanye methods for prevention packages programme (MP3) project', Journal of the International AIDS Society, vol. 23, s6, e25591, pp. 6-16. en_ZA
dc.identifier.issn 1758-2652 (online)
dc.identifier.other 10.1002/jia2.25591
dc.identifier.uri http://hdl.handle.net/2263/78878
dc.language.iso en en_ZA
dc.publisher Wiley Open Access en_ZA
dc.rights © 2020 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society. This is an open access article under the terms of the Creative Commons Attribution License. en_ZA
dc.subject Pre-exposure prophylaxis en_ZA
dc.subject HIV prevention en_ZA
dc.subject Cohort studies en_ZA
dc.subject Human immunodeficiency virus (HIV) en_ZA
dc.subject Men who have sex with men (MSM) en_ZA
dc.subject Sexually transmitted infection (STI) en_ZA
dc.subject Transgender women (TGW) en_ZA
dc.title HIV prevalence and incidence in a cohort of South African men and transgender women who have sex with men: the Sibanye methods for prevention packages programme (MP3) project en_ZA
dc.type Article en_ZA


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