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P714 HIV testing and undiagnosed fraction among adolescent girls and young women by engagement in sex work in mombasa, kenya
  1. Huiting Ma1,
  2. Parinita Bhattacharjee2,
  3. Linwei Wang3,
  4. Vernon Mochache4,
  5. Helgar Musyoki5,
  6. Peter Gichangi6,
  7. James Blanchard7,
  8. Paul Sandstrom8,
  9. Christina Daniuk8,
  10. Stephen Moses7,
  11. Marissa Becker7,
  12. Sharmistha Mishra9
  1. 1St. Michael’s Hospital, Centre for Urban Health Solutions, Toronto, Canada
  2. 2University of Manitoba, Centre for Global Public Health, Nairobi, Kenya
  3. 3St. Michael’s Hospital, Toronto, Canada
  4. 4University of Maryland, Centre for International Health, Education and Biosecurity, Berwyn, USA
  5. 5National AIDS and STI Control Programme, Nairobi, Kenya
  6. 6University of Nairobi, Nairobi, Kenya
  7. 7University of Manitoba, Centre for Global Public Health, Department of Community Health Sciences, Winnipeg, Canada
  8. 8Public Health Agency of Canada, Winnipeg, Canada
  9. 9St. Michael’s Hospital, Li Ka Shing Knowledge Institute, Toronto, Canada


Background Traditional HIV prevention and testing services are generally designed to either reach female sex workers or to reach adolescent girls and young women (AGYW), but not both. We sought to compare the levels and determinants of HIV testing, and the prevalence of undiagnosed HIV across subsets of AGYW in Kenya.

Methods We used data from Transitions, a 2015 cross-sectional survey of 1,299 women age 14–24 years who frequented hotspots associated with formal sex work in Mombasa, Kenya. We compared the prevalence and frequency of recent HIV testing in the previous year between AGYW involved in sex work (YSW, N=408) versus those who did not sell sex (NSW, N=891), and excluding those diagnosed with HIV ≥1 year before the survey. We used logistic regression model to identify univariate determinants of recent testing in each group. We then compared the prevalence of undiagnosed HIV among YSW and NSW living with HIV.

Results Overall, 72% reported a recent HIV test: 85% YSW and 65% NSW (p<0.01), of whom, 42% of YSW and 27% of NSW tested at least twice in the previous year (p<0.01). Shared determinants of recent HIV testing by subgroup included: older age (Odds Ratios [95% Confidence Intervals] for SW: 2.8 (1.6–5.0); NSW: 2.3 [1.7–3.0]), ever contacted by peers/staff from an non-governmental/community-based organization (5.3 [1.6–32.8]; 1.9 [1.1–3.8]), prior pregnancy (1.8 [1.1–3.2]; 2.6 [1.8–3.6]), and recent STI treatment (6.2 [2.2–25.9]; 1.9 [1.3–3.0]). N=37/365 (10%) of YSW and N=30/828 (4%) NSW were living with HIV, of whom only 27% (N=10/37), and 30% (N=9/30) were diagnosed and aware (p=0.79 subgroup comparison).

Conclusion Shared determinants of testing suggest that reaching across high-risk AGYW via hotspot based strategies could fill gaps left by traditional HIV prevention and testing services.

Disclosure No significant relationships.

  • sex workers
  • HIV
  • diagnosis
  • youth

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