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    War-Related Abduction and History of Incarceration Linked to High Burden of HIV among Female Sex Workers in Conflict-Affected Northern Uganda.

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    The final, definitive version of this paper has been published in the Journal of Acquired Immune Deficiency Syndromes, Volume 73, Number 1, September 1, 2016; DOI: 10.1097/QAI.0000000000001030; Published by Wolters Kluwer Health, Inc. All rights reserved. (155.8Kb)
    Date
    2016-09-01
    Author
    Goldenberg, Shira M.
    Muzaaya, Godfrey
    Akello, Monica
    Nguyen, Paul
    Birungi, Josephine
    Shannon, Kate
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    Abstract
    Objective: Sex workers (SWs) in sub-Saharan Africa face a disproportionate HIV burden and growing concerns of severe human rights violations. Given the dearth of evidence on the burden and correlates of HIV among SWs in sub-Saharan Africa, particularly within conflict-affected settings, we examined the relationship between structural determinants (eg, war-related abduction, incarceration) and HIV infection among conflict-affected SWs in Northern Uganda. Design: Cross-sectional community-based research study among female SWs in conflict-affected Gulu, Northern Uganda. Results: Of 400 SWs, 135 (33.75%) were HIV seropositive; of whom one-third were new/previously undiagnosed HIV infections. In multivariable analysis, after adjusting for age of sex work entry and education, lifetime incarceration (adjusted odds ratio: 1.93, 95% confidence interval: 1.17 to −3.20) was independently associated with HIV seroprevalence, and history of wartime abduction (adjusted odds ratio: 1.62, 95% confidence interval: 1.00 to 2.63) was marginally associated (P = 0.051). Conclusions: This study documented a high rate of undiagnosed HIV infections and associations between war-related human rights violations, incarceration, and a heavy HIV burden among SWs in conflict-affected Northern Uganda. These findings highlight the serious harms of conflict and criminalization of marginalized women in sub-Saharan African contexts. SW-led interventions that address conflict experiences and policy shifts to promote a rights-based approach to HIV prevention and care remain critically needed.
    Use this URI to cite this item:
    https://hdl.handle.net/20.500.11951/275
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