Namale, GertrudeKamacooko, OnesmusBagiire, DanielMayanja, YuniaAbaasa, AndrewKilembe, WilliamPrice, MattSsemwanga, DeogratiusLunkuse, SandraNanyonjo, MariaSsenyonga, WilliamMayaud, PhilippeNewton, RobKaleebu, PontianoSeeley, Janet2022-05-082022-05-082019Namale, G., Kamacooko, O., Bagiire, D., Mayanja, Y., Abaasa, A., Kilembe, W., ... & Seeley, J. (2019). Sustained virological response and drug resistance among female sex workers living with HIV on antiretroviral therapy in Kampala, Uganda: a cross-sectional study. Sexually transmitted infections, 95(6), 405-411. doi:10.1136/sextrans-2018-05385410.1136/sextrans-2018-053854https://nru.uncst.go.ug/handle/123456789/3208We assessed the prevalence and risk factors associated with virological failure among female sex workers living with HIV on antiretroviral therapy (ART ) in Kampala, Uganda. Methods We conducted a cross-sectional study between January 2015 and December 2016 using routinely collected data at a research clinic providing services to women at high risk of STIs including HIV. Plasma samples were tested for viral load from HIVseropositive women aged ≥18 years who had been on ART for at least 6 months and had received adherence counselling. Samples from women with virological failure (≥1000 copies/mL) were tested for HIV drug resistance by population-based sequencing. We used logistic regression to identify factors associated with virological failure. Results Of 584 women, 432 (74%) with a mean age of 32 (SD 6.5) were assessed, and 38 (9%) were found to have virological failure. HIV resistance testing was available for 78% (28/38), of whom 82.1% (23/28) had at least one major drug resistance mutation (DRM), most frequently M184V (70%, 16/23) and K103N (65%, 15/23). In multivariable analysis, virological failure was associated with participant age 18–24 (adjusted OR (aOR)=5.3, 95% CI 1.6 to 17.9), self-reported ART nonadherence (aOR=2.6, 95% CI 1.2 to 5.8) and baseline CD4+ T-cell count ≤350 cells/mm3 (aOR=3.1, 95% CI 1.4 to 7.0). Conclusions A relatively low prevalence of virological failure but high rate of DRM was found in this population at high risk of transmission. Younger age, self-reported ART non-adherence and low CD4+ T-cell count on ART initiation were associated with increased risk of virological failure.enDrug resistanceFemale sex workersHIVAntiretroviral therapyUgandaArticle