Adherence to antiretroviral therapy among Female Sex Workers in Kampala Uganda

BackgroundIncreased access to ART to key populations who bear a disproportionate burden of HIV, including female sex workers, provides a great opportunity to reduce onward transmission. This is however dependent on achieving high levels of adherence to ART. We set out to determine level of adherence to ART and associated factors among female sex workers in Uganda. MethodsIn this cross-sectional study between May and June 2017, we consecutively enrolled 226 female sex workers accessing HIV care at an urban clinic in Kampala, Uganda. We assessed self-reported adherence using interviewer administered questionnaires and reviewing medical records. We defined high level adherence as those who scored [≥]95% at assessment. Using multivariable logistic regression, we identified factors independently associated with adherence. ResultsOverall, 59.2 % of participants were adherent to ART. Major reasons for non-adherence were being away from home (40.8%) and forgetfulness (26.7%). In the multivariable model, owning a phone (AOR 2.90; 95% CI 1.07, 7.88), a 10-year increase in age (AOR 1.60; 95% CI 1.00, 2.60) and being a widow (AOR 0.22; 95% CI 0.05, 0.87) were independently associated with adherence. ConclusionOur study found low observed adherence to ART among female sex workers in Uganda. This baseline assessment builds a case for the development and scale up of targeted intervention strategies to increase to ART adherence among female sex workers. Incorporating information and communication technology such as mobile phones in routine adherence counselling could be scaled up among key populations such as female sex workers.