UNMET HIV TREATMENT NEEDS TO PREVENT VERTICAL TRANSMISSION AMOMG FEMALE SEX WORKERS IN LESOTHO

Background: Despite considerable advances made to increase the accessibility of non-barrier contraceptives across Sub-Saharan Africa, their use continues to be constrained within the region. Within the high HIV burden environment in Sub- Saharan Africa including Lesotho, a low uptake of non-barrier contraceptives increases the risk of the risk of unwanted pregnancies and vertical transmission of HIV in the absence of continued engagement in HIV care. These risks are further amplified among Female Sex Workers may also be less likely to consistently engage in health facilities during antenatal and postnatal periods. Therefore, in these analyses we assess contraceptive uptake among FSW and aim to assess the correlates of engagement in HIV care among FSW not using non-barrier methods of contraception and thus may be at increased risk for unplanned pregnancy and vertical transmission. Methods: In 2014, 744 FSW were recruited through respondent driven sampling and administered a structured questionnaire and HIV testing across Maputsoe and Maseru, Lesotho. Robust Poisson regression was used to estimate prevalence ratios of correlates of engagement in HIV care among HIV-positive FSWs who were not using non-barrier contraceptive methods. Results: In total, 287/744 (39%) FSW of reproductive age were living with HIV and not using HC/LARC methods; of these only 32% (92/287) were using ART. In multivariate analyses, each additional year of age was independently associated with a 6% increase in ART utilization [aPrR: 1.06 (1.04 to 1.08); p