Trial reportJournal of acquired immune deficiency syndromes (1999)2019
How Can Programs Better Support Female Sex Workers to Avoid HIV Infection in Zimbabwe? A Prevention Cascade Analysis.
Trial report in Journal of acquired immune deficiency syndromes (1999), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed.
- "We carried her in a wheelbarrow to the clinic": process evaluation of the AMETHIST intervention combining microplanning with self-help groups to improve HIV prevention and treatment among female sex workers in Zimbabwe.BMC health services research · 2026Trial
- Trial
- The impact of the DREAMS partnership on HIV incidence among young women who sell sex in two Zimbabwean cities: results of a non-randomised study.BMJ global health · 2021Trial
- "It would have been easier for me to give up if I were alone": how a pilot individualized case management intervention influenced female sex workers' oral HIV pre-exposure prophylaxis use in eThekwini, South Africa.BMC public health · 2026Article
- Appraising the HIV prevention cascade methodology to improve HIV prevention targets: Lessons learned from a general population pilot study in east Zimbabwe.PLOS global public health · 2026Article
- Beyond barriers: The role of preexposure prophylaxis in the prevention of human immunodeficiency virus in women.The Journal of international medical research · 2025Review
- Condomless sexual encounters among female sex workers included in a longitudinal coital diary study in Zimbabwe.BMC public health · 2025Article
- "I will take PrEP because that's what will help me not to get infected with HIV": barriers to and facilitators of pre-exposure prophylaxis and condom use among adolescent girls and young women enrolled in a school-based HIV prevention program in South Africa.Frontiers in public health · 2025Article
- Factors Associated with Usage of Oral-PrEP among Female Sex Workers in Nairobi, Kenya, Assessed by Self-Report and a Point-of-Care Urine Tenofovir Immunoassay.AIDS and behavior · 2024Article
- Applying the HIV Prevention Cascade to an Evaluation of a Large-Scale Combination HIV Prevention Programme for Adolescent Girls and Young Women in South Africa.AIDS and behavior · 2024Article
- Early disengagement from HIV pre-exposure prophylaxis services and associated factors among female sex workers in Dar es Salaam, Tanzania: a socioecological approach.BMJ global health · 2023Article
- Alcohol use and associated risk factors among female sex workers in low- and middle-income countries: A systematic review and meta-analysis.PLOS global public health · 2023Article
- 'I was in need of somewhere to release my hurt:' Addressing the mental health of vulnerable adolescent mothers in Harare, Zimbabwe, through self-help groups.Global health action · 2022Article
- Harmful Alcohol Use and Associated Socio-Structural Factors among Female Sex Workers Initiating HIV Pre-Exposure Prophylaxis in Dar es Salaam, Tanzania.International journal of environmental research and public health · 2022Article
- PrEP acceptability and initiation among women engaged in sex work in Uganda: Implications for HIV prevention.EClinicalMedicine · 2022Article
- Stigma, Social Support, and Sexual Behavior Among Female Sex Workers at Risk for HIV in Malawi.AIDS education and prevention : official publication of the International Society for AIDS Education · 2021Article
- Addressing Unhealthy Alcohol Use and the HIV Pre-exposure Prophylaxis Care Continuum in Primary Care: A Scoping Review.AIDS and behavior · 2021Article
- Women at high risk of HIV-infection in Kampala, Uganda, and their candidacy for PrEP.SSM - population health · 2021Article
- "Feeling Safe, Feeling Seen, Feeling Free": Combating stigma and creating culturally safe care for sex workers in Chicago.PloS one · 2021Article
- Condom use among young women who sell sex in Zimbabwe: a prevention cascade analysis to identify gaps in HIV prevention programming.Journal of the International AIDS Society · 2020Article
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
background"HIV prevention cascades" have been proposed to support programs by identifying gaps in demand for, access to, and capability to adhere to HIV prevention tools, but there are few empirical examples to guide development. We apply a prevention cascade framework to examine prevention coverage and factors associated with condoms and/or PrEP adherence among female sex workers.
settingSeven sites across Zimbabwe.
methodsSeven respondent-driven sampling surveys from the intervention sites of a pragmatic cluster-randomized trial in Zimbabwe in 2016 were analyzed, and 611/1439 women testing HIV-negative included. We operationalized key components of an HIV prevention cascade including demand, supply, and capability to adhere to 2 tools for HIV prevention: condoms and pre-exposure prophylaxis (PrEP). We used adjusted logistic regression to identify determinants of adherence to condoms and PrEP in turn, examining the effect of adherence to one tool on adherence to the other.
resultsThere were 343/611, 54.7%, women reporting adherence to condoms and/or PrEP, leaving almost half uncovered. Although women were aware that condoms prevented HIV and reported good access to them, only 45·5% reported full adherence to condom use. For PrEP, a new technology, there were gaps along all 3 domains of demand, supply, and adherence. Alcohol use decreased adherence to PrEP and condoms. Younger and newer entrants to sex work were less likely to take PrEP every day.
conclusionsHIV prevention programming among female sex workers in Zimbabwe could consider increasing awareness of PrEP alongside supply, alcohol use interventions, and approaches to engaging younger women.
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