Venue-based HIV testing at sex work hotspots to reach adolescent girls and young women living with HIV: a cross-sectional study in Mombasa, Kenya

Huiting Ma; Linwei Wang; Peter Gichangi; Vernon Mochache; Griffins Manguro; Helgar K Musyoki; Parinita Bhattacharjee; François Cholette; Paul Sandstrom; Marissa L Becker; Sharmistha Mishra

arXiv · 1912.04949

Venue-based HIV testing at sex work hotspots to reach adolescent girls and young women living with HIV: a cross-sectional study in Mombasa, Kenya

Huiting Ma·Linwei Wang·Peter Gichangi·Vernon Mochache·Griffins Manguro·Helgar K Musyoki·Parinita Bhattacharjee·François Cholette·Paul Sandstrom·Marissa L Becker·Sharmistha Mishra

View original source ↗Read source document ↗Export metadata ↓

Abstract

Background: We estimated the potential number of newly diagnosed HIV infections among adolescent girls and young women (AGYW) using a venue-based approach to HIV testing at sex work hotspots. Methods: We used hotspot enumeration and cross-sectional bio-behavioural survey data from the 2015 Transitions Study of AGYW aged 14-24 years who frequented hotspots in Mombasa, Kenya. We compared the HIV cascade among AGYW who sell sex (YSW, N=408) versus those who do not (NSW, N=891); and triangulated the potential (100% test acceptance and accuracy) and feasible (accounting for test acceptance and sensitivity) number of AGYW that could be newly diagnosed via hotspot-based HIV rapid testing in Mombasa. We identified the profile of AGYW recently tested for HIV (in the past year) using multivariable logistic regression. Results: N=37/365 (10.1%) YSW and N=30/828 (3.6%) NSW were living with HIV, of whom 27.0% (N=10/37) and 30.0% (N=9/30) were diagnosed and aware (p=0.79). Rapid test acceptance was 89.3% and sensitivity was 80.4%. Hotspot enumeration estimated 15,635 (range: 12,172-19,097) AGYW in hotspots in Mombasa. The potential and feasible number of new diagnosis were 627 (310-1,081), and 450 (223-776), respectively. Thus, hotspot-based testing could feasibly reduce the undiagnosed fraction from 71.6% to 20.2%. The profile of AGYW who recently tested was similar among YSW and NSW. YSW were two-fold more likely to report a recent HIV test after adjusting for other determinants [odds ratio (95% CI): 2.1 (1.6-3.1)]. Conclusion: Reaching AGYW via hotspot-based HIV testing could fill gaps left by traditional, clinic-based HIV prevention and testing services.

Explore related subjects

q-bio.OT

Keep this discovery

BibTeX RIS

Huiting Ma, Linwei Wang, Peter Gichangi, Vernon Mochache, Griffins Manguro, Helgar K Musyoki, Parinita Bhattacharjee, François Cholette, Paul Sandstrom, Marissa L Becker, Sharmistha Mishra. 2019-12-10. Venue-based HIV testing at sex work hotspots to reach adolescent girls and young women living with HIV: a cross-sectional study in Mombasa, Kenya. https://arxiv.org/abs/1912.04949

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related papers

arXiv2026

MarkerScout: A Disease-Agnostic Machine Learning Framework for Biomarker Prediction from Multi-Scale Mechanistic Models

We demonstrate the framework on three infectious diseases derived from a companion mechanistic immune-simulation platform: SARS-CoV-2, Influenza A Virus, and Plasmodium falciparum. Each disease was evaluated across hospitalization and intensive care unit cohorts, yielding six cohorts in total. Best-pipeline cross-validated macro F1 ranged from 0.82 for IAV-HOSP to 0.99 for COV-ICU, and the framework produced tiered, direction-aware biomarker lists for each disease and phase. Interleukin-18 (IL-18) reached the strongest tier in both SARS-CoV-2 phases with consistent direction. When benchmarked against three separate, independently collected clinical ICU datasets, MarkerScout's top-ranked features outperformed 94.4% of randomly selected feature sets of equivalent size for SARS-CoV-2, with a weaker but directionally consistent advantage for Influenza A Virus (66.7%) and Plasmodium falciparum (60.7%).

q-bio.OT↗

arXiv2026

Enhancing Clinical Decision Support and Differential Diagnosis with Knowledge Graphs, and Retrieval Augmented Generation in Generative AI

Diagnostic error carries a burden, while unconstrained large language models (LLMs) remain vulnerable to hallucination and weak integration of quantitative laboratory dynamics. We developed a decision-support pipeline combining disease-specific biomarker correlation graphs, ordinary differential equations (ODEs), deep sequence classification, and retrieval-augmented generation (RAG). For 103 disease classes from a full blood count (FBC) repository, biomarker networks were used as coupling matrices to generate 30 trajectories per disease (3,090 total). A one-dimensional convolutional neural network (CNN) and long short-term memory (LSTM) network classified disease trajectories and six dynamical clusters. A constrained GPT-4o-mini RAG layer used a 19-pattern BMJ Best Practice/NICE corpus to generate differential diagnoses evaluated for diagnostic suitability, evidential grounding, and clinical plausibility. Across five random-seed runs, disease-level accuracy was $0.940 \pm 0.006$ for the CNN (95\% CI 0.933--0.948) and $0.852 \pm 0.019$ for the LSTM (95\% CI 0.828--0.875); the CNN advantage was 8.87 percentage points (95\% CI 6.47--11.27; $t(4)=10.26$, $p=5.1\times10^{-4}$; Hedges' $g=3.67$). Among 100 sampled RAG cases, 96 parsed successfully; evidence was cited in 97.9\%, the true diagnosis was mentioned in 71.9\%, and the composite score was 3.82/5 with a 47.9\% strict pass rate. The central finding was a decoupling between grounding and diagnostic correctness: classifier-correct versus classifier-wrong outputs differed in diagnostic suitability but not evidential grounding. Post-hoc analysis confirmed a 1.02-point diagnostic-score difference (Mann--Whitney $p=0.0024$; Hedges' $g=0.72$), whereas grounding differed by only $-0.02$ points ($p=0.839$; $g=-0.04$).

q-bio.OT↗

arXiv2026

Expanding the Human Ancestry Ontology to include under-represented populations and ethnicities for broader utility in annotations

Successful discovery, integration and reuse of data relies on the availability of rich, well-structured and machine-readable metadata to describe every aspect of the data, from sample sources to collection processes to experimental protocols. The use of standardised terminologies to express concepts in a harmonised fashion lies at the core of high-quality data annotation, increasing the FAIRness of the data, facilitating data integration and promoting reproducibility. Here, we describe the Human Ancestry Ontology (HANCESTRO), originally developed to improve standardised reporting of genetic ancestry genomic resources such as the NHGRI-EBI GWAS Catalog and the Human Cell Atlas through high-level population descriptors, and more recently expanded to include diverse and previously under-represented populations in genomics and genetics research. HANCESTRO provides a framework for population descriptors that includes both ancestry based on the analysis of genetic information and self-reported ethnicity, which is based on social and cultural factors that don't necessarily align with genetic populations. By enabling the accurate and interoperable representation of population-related data, it promotes inclusive, representative and reproducible science.

q-bio.OT↗