Examining factors associated with health-related quality of life among female sex workers living with HIV in South Africa

The paper is published in the Journal of the International AIDS Society.


Why did we conduct this study?

Health-related quality of life (HRQoL) is an important HIV outcome beyond viral suppression. However, there is limited data on HRQoL among female sex workers (FSW) living with HIV.

What did we do?

Using baseline data (June 22,2018 to March 23,2020) of FSW who were diagnosed with HIV and enrolled into a randomized trial in Durban, South Africa, we estimated HRQoL scores which represent health utilities, and identified characteristics associated with HRQoL scores.

What did we find?

We found older age, drug use, experience of violence, and moderate (vs. no) level of internalized stigma were associated with a lower HRQoL score. Current ART use was associated with a higher HRQoL score.

What do these findings mean?

  1. Our results can be translated into a reduction in 37,184 and 39,722 quality adjusted life years related to drug use and experience of violence, respectively in South Africa.
  2. The findings reinforce the importance for HIV and sex worker programs to develop and adopt a comprehensive, and human-centered approach, with tailored services designed to address social and structural vulnerabilities including drug use, violence, and stigma to improve HRQoL among FSW living with HIV.

This research was led by Linwei Wang. The study was conducted in collaboration with Johns Hopkins University and was funded by the National Institutes of Health.

Figure. Estimated mean and 95% confidence intervals of health-related quality of life (HRQoL) score (representing health utility) for subgroups of female sex workers (FSW) living with HIV in Durban, South Africa by current antiretroviral treatment (ART) use.

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