title: High human immunodeficiency virus incidence in a cohort of Rwandan female sex workers.
abstract: BACKGROUND
  Measurement of human immunodeficiency virus(HIV) incidence among female sex workers in Rwanda is a key part of preparing for HIV prevention trials.
  
  
  METHODS
  HIV-negative, nonpregnant female sex workers (N =397) were tested for HIV-1, sexually transmitted infections, and pregnancy quarterly for 12 months, and again at a 1-time year 2 visit. Additional women (N=156) were tested for HIV at baseline and 6 to 12 months thereafter in a parallel study.
  
  
  RESULTS
  A total of 19 participants seroconverted during follow-up,with 13 in the first 12 months. The 12-month HIV incidence rate (IR)was 3.5 (95% confidence interval: 1.6, 5.4) per 100 person-years (PY).There was a nonsignificant downward trend from 4.6/100 PY (1.6, 7.7)in the first 6 months to 2.2 (0.1, 4.4) in the second 6 months (IR ratio:2.1 [95% confidence interval: 0.7, 7.8]). The year 2 IR was 2.1 (0.4,3.7), and the HIV IR in the parallel study (in the absence of frequent study visits) was 3.3/100 PY (0, 7.0). HIV testing history, lifetime pregnancies, recent initiation of sex work, gonorrhea, syphilis, and change in reproductive intentions were associated with incident HIV infection. Incidence of pregnancy, herpes simplex virus-type 2,trichomoniasis, gonorrhea, chlamydia, and syphilis per 100 PY were as follows: 26.3 (21.9, 30.7), 8.7 (4.0, 13.4), 16.9 (12.7, 21.1), 12.1 (8.2,15.9), 8.1 (5.1, 11.2), and 6.2 (3.7, 8.7).
  
  
  CONCLUSIONS
  The HIV/sexually transmitted infections burden int his group was high. HIV IR was highest in the first 6 months of the cohort, and in the parallel study in which there were no risk-reduction procedures. HIV prevention and family planning interventions are needed.
authors.affiliation: Mailman School of Public Health, Columbia University, New York, NY, USA. braunstein.sarah@gmail.com
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Braunstein
authors.forename: Chantal M
authors.initials: CM
authors.lastname: Ingabire
authors.forename: Evelyne
authors.initials: E
authors.lastname: Kestelyn
authors.forename: Aline Umutoni
authors.initials: AU
authors.lastname: Uwizera
authors.forename: Lambert
authors.initials: L
authors.lastname: Mwamarangwe
authors.forename: Justin
authors.initials: J
authors.lastname: Ntirushwa
authors.forename: Denis
authors.initials: D
authors.lastname: Nash
authors.forename: Nienke J
authors.initials: NJ
authors.lastname: Veldhuijzen
authors.forename: Annalene
authors.initials: A
authors.lastname: Nel
authors.forename: Joseph
authors.initials: J
authors.lastname: Vyankandondera
authors.forename: Janneke H H M
authors.initials: JH
authors.lastname: van de Wijgert
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011247:Pregnancy / Q000706:statistics & numerical data; D015995:Prevalence; D012432:Rwanda / Q000453:epidemiology; D011477:Sex Work; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
chemical_list: D015483:HIV Antibodies