Engagement in the HIV Care Continuum among Key Populations in Tijuana, Mexico.
In Tijuana, Mexico, HIV is concentrated in sub-epidemics of key populations: persons who inject drugs (PWID), sex workers (SW), and men who have sex with men (MSM). To date, data on engagement in the HIV care continuum among these key populations, particularly in resource-constrained settings, are sparse. We pooled available epidemiological data from six studies (N = 3368) to examine HIV testing and treatment uptake in these key populations; finding an overall HIV prevalence of 5.7 %. Of the 191 identified HIV-positive persons, only 11.5 % knew their HIV-positive status and 3.7 % were on ART. Observed differences between these HIV-positive key populations suggest PWID (vs. non-PWID) were least likely to have previously tested or initiate HIV care. MSM (vs. non-MSM) were more likely to have previously tested but not more likely to know their HIV-positive status. Of persons aware of their HIV-positive status, SW (vs. non-SW) were more likely to initiate HIV care. Findings suggest engagement of key populations in HIV treatment is far below estimates observed for similarly resource-constrained generalized epidemics in sub-Saharan Africa. These data provide one of the first empirical-snapshots highlighting the extent of HIV treatment disparities in key populations.
Division of Global Public Health, Department of Medicine, University of California, San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA. laramie@ucsd.edu.
Laramie R
LR
Smith
Department of Psychiatry, University of California, San Diego, La Jolla, USA.
Thomas L
TL
Patterson
Centro Nacional para la Prevención y el Control del VIH y SIDA (CENSIDA), Mexico City, Mexico.
Carlos
C
Magis-Rodriguez
Division of Global Public Health, Department of Medicine, University of California, San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA.
Victoria D
VD
Ojeda
Division of Global Public Health, Department of Medicine, University of California, San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA.
Jose Luis
JL
Burgos
Family Health Centers of San Diego, San Diego, USA.
Sarah A
SA
Rojas
School of Social Work, San Diego State University, San Diego, USA.
María Luisa
ML
Zúñiga
Division of Global Public Health, Department of Medicine, University of California, San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA.
Steffanie A
SA
Strathdee
D000293:Adolescent; D000328:Adult; D001364:Awareness; D003266:Continuity of Patient Care; D055030:Drug Users; D058872:Epidemics; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008403:Mass Screening; D008800:Mexico / Q000453:epidemiology; D015995:Prevalence; D060386:Sex Workers; D015819:Substance Abuse, Intravenous / Q000150:complications*
HIV Continuum of Care; HIV testing; Key populations; Secondary HIV prevention