Community-based antiretroviral therapy (ART) delivery for female sex workers in Tanzania: 6-month ART initiation and adherence
W. Tun, L. Apicella, C. Casalini, D. Bikaru, G. Mbita, K. Jeremiah, N. Makyao, T. Koppenhaver, E. Mlanga, L. Vu
2019. AIDS and Behavior. 23(Suppl 2): 142–152
We conducted an implementation science study of a community-based ART distribution program for HIV-positive female sex workers (FSWs) whereby clients received antiretroviral therapy (ART) services through community-based mobile and home-based platforms. We compared 6-month treatment-related outcomes in the community-based ART arm (N = 256) to the standard facility-based ART delivery arm (N = 253). Those in the intervention arm were more likely to have initiated ART (100.0% vs. 71.5%; p = 0.04), be currently taking ART at the 6-month visit (100.0% vs. 95.0%; p < 0.01), and less likely to have stopped taking ART for more than 30 days continuously (0.9% vs. 5.7%; p = 0.008) or feel high levels of internalized stigma (26.6% vs. 39.9%; p = 0.001). In the adjusted regression model, internalized stigma (adjusted OR [aOR]: 0.5; 95% CI 0.28–0.83) and receiving community-based ART (aOR: 208.6; 95% CI 12.5–3479.0) were significantly associated with ART initiation. Community-based ART distribution model can improve linkage to and adherence to ART over standard facility-based ART programs for FSWs.