{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T20:14:55Z","timestamp":1762460095956,"version":"3.37.3"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T00:00:00Z","timestamp":1656374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006661","name":"United Nations Population Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006661","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["1K01MH110316"],"award-info":[{"award-number":["1K01MH110316"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Introduction<\/jats:title><jats:p>Young female sex workers (FSW) are disproportionately vulnerable to HIV. Zimbabwe data show higher HIV incidence and lower engagement in services compared to older FSW. Utilizing data from a combination HIV prevention and treatment intervention, we describe engagement in the HIV services over time among FSW 18\u201324 years, compared to those \u226525 years of age.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Materials and methods<\/jats:title><jats:p>Data were collected via respondent-driven sampling (RDS) surveys in 14 communities in 2013 and 2016, with &gt;2500 FSW per survey. They included blood samples for HIV and viral load testing. As the intervention had no significant impact on HIV care cascade outcomes, data were aggregated across study arms. Analyses used RDS-II estimation.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>Mean age in 2013 and 2016 was 31 and 33 years, with 27% and 17% aged 18\u201324 years. Overall HIV prevalence was 59% at each timepoint, and 35% and 36% among younger FSW. From 2013 to 2016 there was an increase in young HIV-positive FSW knowing their status (38% vs 60%, OR = 2.51, p&lt;0.01). Outcomes for all FSW improved significantly over time at all steps of the cascade, and the relative change over time was similar among older versus younger FSW for most cascade variables.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Discussion<\/jats:title><jats:p>Young FSW had improvements in care cascade outcomes, and proportionate improvements similar to older FSW, yet they remain less engaged in services overall. This implies that the dedicated FSW services in Zimbabwe are having a comparably positive impact across age groups, however more is likely required to address young FSW\u2019s unique vulnerabilities and needs.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0270298","type":"journal-article","created":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T18:31:26Z","timestamp":1656441086000},"page":"e0270298","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Engagement in HIV services over time among young women who sell sex in Zimbabwe"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1146-8154","authenticated-orcid":true,"given":"Sue","family":"Napierala","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7629-1543","authenticated-orcid":true,"given":"Sungai T.","family":"Chabata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Calum","family":"Davey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Fearon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"Busza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillis","family":"Mushati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Owen","family":"Mugurungi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Hatzold","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Cambiano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Phillips","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James R.","family":"Hargreaves","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3087-4422","authenticated-orcid":true,"given":"Frances M.","family":"Cowan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,6,28]]},"reference":[{"issue":"5","key":"pone.0270298.ref001","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1136\/adc.2009.178715","article-title":"Adolescent female sex workers: invisibility, violence and HIV","volume":"96","author":"JG Silverman","year":"2011","journal-title":"Archives of disease in childhood"},{"issue":"3","key":"pone.0270298.ref002","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1097\/QAI.0000000000001815","article-title":"Engagement in HIV Care Among Young Female Sex Workers in Zimbabwe","volume":"79","author":"S Napierala","year":"2018","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"Suppl 2","key":"pone.0270298.ref003","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1080\/09540121.2016.1176673","article-title":"Underage and underserved: reaching young women who sell sex in Zimbabwe","volume":"28","author":"J Busza","year":"2016","journal-title":"AIDS Care"},{"issue":"2 Suppl 1","key":"pone.0270298.ref004","doi-asserted-by":"crossref","first-page":"19833","DOI":"10.7448\/IAS.18.2.19833","article-title":"Providing comprehensive health services for young key populations: needs, barriers and gaps","volume":"18","author":"S Delany-Moretlwe","year":"2015","journal-title":"J Int AIDS Soc"},{"key":"pone.0270298.ref005","unstructured":"Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations\u20142016 Update. 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