Engagement in Antiretroviral Treatment and Modern Contraceptive Methods Among Female Sex Workers Living With HIV in Lesotho

Female sex workers (FSW) are disproportionately affected by HIV in Lesotho, which highlights the importance of contraception and antiretroviral therapy (ART) given occupational risks of unwanted pregnancies. Seven hundred and forty-four FSW recruited through respondent-driven sampling in Maputsoe and Maseru in Lesotho completed a questionnaire and HIV testing in 2014. RDS-adjusted HIV prevalence was high (66.1; 95% CI: 58.7–72.8); 56% of HIV + participants were not using non-barrier contraception, and 32% were on ART. Among HIV-positive FSW not using non-barrier contraception, negative correlates of ART engagement were older age, lower HIV education, and consuming 5+ alcoholic drinks/day. Tailored HIV information delivery efforts for FSW in Lesotho’s high HIV burden environment may reduce horizontal and vertical transmission risks.