RT Journal Article SR Electronic T1 Sustained virological response and drug resistance among female sex workers living with HIV on antiretroviral therapy in Kampala, Uganda: a cross-sectional study JF Sexually Transmitted Infections JO Sex Transm Infect FD BMJ Publishing Group Ltd SP 405 OP 411 DO 10.1136/sextrans-2018-053854 VO 95 IS 6 A1 Gertrude Namale A1 Onesmus Kamacooko A1 Daniel Bagiire A1 Yunia Mayanja A1 Andrew Abaasa A1 William Kilembe A1 Matt Price A1 Deogratius Ssemwanga A1 Sandra Lunkuse A1 Maria Nanyonjo A1 William Ssenyonga A1 Philippe Mayaud A1 Rob Newton A1 Pontiano Kaleebu A1 Janet Seeley YR 2019 UL http://sti.bmj.com/content/95/6/405.abstract AB Objectives We assessed the prevalence and risk factors associated with virological failure among female sex workers living with HIV on antiretroviral therapy (ART) in Kampala, Uganda.Methods We conducted a cross-sectional study between January 2015 and December 2016 using routinely collected data at a research clinic providing services to women at high risk of STIs including HIV. Plasma samples were tested for viral load from HIV-seropositive women aged ≥18 years who had been on ART for at least 6 months and had received adherence counselling. Samples from women with virological failure (≥1000 copies/mL) were tested for HIV drug resistance by population-based sequencing. We used logistic regression to identify factors associated with virological failure.Results Of 584 women, 432 (74%) with a mean age of 32 (SD 6.5) were assessed, and 38 (9%) were found to have virological failure. HIV resistance testing was available for 78% (28/38), of whom 82.1% (23/28) had at least one major drug resistance mutation (DRM), most frequently M184V (70%, 16/23) and K103N (65%, 15/23). In multivariable analysis, virological failure was associated with participant age 18–24 (adjusted OR (aOR)=5.3, 95% CI 1.6 to 17.9), self-reported ART non-adherence (aOR=2.6, 95% CI 1.2 to 5.8) and baseline CD4+ T-cell count ≤350 cells/mm3 (aOR=3.1, 95% CI 1.4 to 7.0).Conclusions A relatively low prevalence of virological failure but high rate of DRM was found in this population at high risk of transmission. Younger age, self-reported ART non-adherence and low CD4+ T-cell count on ART initiation were associated with increased risk of virological failure.