Low levels of early HIV testing among children of sex workers living with HIV in Cameroon: the importance of engagement in health services
In 2015, over 4000 babies were born with HIV in the Central African country of Cameroon. The best estimates of life expectancy at birth suggest that these children will only live on average for about 2 years. And while the estimate of 4000 babies born with HIV is high, it may be an underestimate of the true number given the limited infant testing for HIV that takes place.
Most children born to mom’s living with HIV have negligible risks for actually acquiring the infection. But children of sex workers living with HIV around the world have significant risks for HIV given the structural barriers to HIV prevention and treatment services that disproportionately affect sex workers. Indeed, the majority of female sex workers are mothers and in Cameroon specifically, over one third are living with HIV. In this study, we wanted to look at the specific HIV treatment and prevention needs among sex workers and their children in five cities in Cameroon. To do this, we examined levels and predictors of early childhood testing among children of female sex workers living with HIV.
More than half of the sex workers included in our study did not know of their positive HIV status and one out of six reported not attending antenatal care during her last pregnancy, highlighting the limited engagement in healthcare services for themselves. More than two thirds of sex workers in the study reported that none of their children had tested for HIV before the age of five. But among those who did test, 3.5% reported that one or more of their children had already been diagnosed with HIV. Engaging in antenatal care was an important predictor of increased levels of child HIV testing. The results of this study highlight the need to prioritize the health of the mother through early and continued engagement in testing and care, for her own care and also for the well-being of her child. Criminalization of sex work in Cameroon challenges engagement in antenatal care for female sex workers and uptake of much needed health services for their children, severely undermining treatment of existing infections and prevention of new ones.
The full article has been published in BMC public health under the title: Predictors of early childhood HIV testing among children of sex workers living with HIV in Cameroon and may be found on this link: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-6812-3