Changes Over Time in HIV Prevalence and Sexual Behaviour Among Young Female Sex-Workers in 14 Sites in Zimbabwe, 2013–2016

Abstract Background: In Uganda, female sex workers (FSWs) and their male partners are estimated to contribute 16% to new HIV infections. We assessed HIV prevalence and associated sexual behaviour risk among male regular partners of FSWs attending a peri-urban clinic in Kampala, Uganda.Methods: Between June 2012 - June 2017, we conducted a mixed methods cross-sectional study among male regular partners (aged ≥18 years old) of FSWs. The men were enrolled through FSWs attending a routine three monthly visit at a research clinic. Eligible and interested men were consented and counselled for parallel rapid HIV testing (Determine, Statpak, Unigold) on a serum sample. HIV-positive men were assessed and enrolled into HIV care and 3 monthly follow up. Data on socio-demographic, sexual behaviour (sexual relationships, condom and alcohol use), and clinical characteristics were collected. Multivariable logistic regression was used to identify factors associated with HIV sero-positivity. In-depth interviews were conducted to elicit information on participants’ knowledge of HIV and its prevention as well as sexual risk practices. Qualitative data was analysed using NVIVO 12.0 following thematic approach.Results: One hundred and sixty-two men were included in the analysis; mean age was 35 years old (SD± 8.43). The overall HIV sero-positivity was 65/162 (40%), of these 57/65 (88%) men were initiated on ART from the clinic. Ninety percent had no signs of sexually transmitted infections (STI), 119/162 (73%) reported not using a condom during last sexual intercourse. At adjusted analysis, HIV sero-positivity was less likely among men with no STI (aOR= 0.21; 95% CI: 0.06-0.70) and using a condom during last sexual intercourse (aOR = 0.39 (95% CI: 0.18-0.85). HIV sero-positivity was more likely among uncircumcised men (aOR=3.10; 95%CI: 1.49-6.45), those with multiple sexual relationships (two or more sexual partners] (aOR= 3.45; 95% CI: 1.59-7.51). Qualitative findings highlight that most participants were not consistently using condoms with FSWs; the main reason given was that they “trusted” their steady FSWs.Conclusions: HIV prevalence among male regular partners was associated with high risk sexual behaviour. Interventions targeting FSWs should be extended to their male regular partners, to enable their access to HIV care and support.

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Sexual behaviour, structural vulnerabilities and HIV prevalence among female sex workers in Pakistan

Sexually Transmitted Infections ◽

10.1136/sextrans-2012-050776 ◽

2013 ◽

Vol 89 (Suppl 2) ◽

pp. ii34-ii42 ◽

Cited By ~ 12

Author(s):

Sharmistha Mishra ◽

Laura H Thompson ◽

Altaf Sonia ◽

Nosheen Khalid ◽

Faran Emmanuel ◽

...

Keyword(s):

Sexual Behaviour ◽

Sex Workers ◽

Female Sex Workers ◽

Hiv Prevalence ◽

Female Sex

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Unexpectedly high HIV prevalence among female sex workers in Bangkok, Thailand in a respondent-driven sampling survey

International Journal of STD & AIDS ◽

10.1177/0956462412472300 ◽

2013 ◽

Vol 24 (1) ◽

pp. 34-38 ◽

Cited By ~ 20

Author(s):

C Manopaiboon ◽

D Prybylski ◽

W Subhachaturas ◽

S Tanpradech ◽

O Suksripanich ◽

...

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

Hiv Prevalence ◽

Respondent Driven Sampling ◽

Female Sex ◽

Sampling Survey

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Testing for amphetamine-type stimulant (ATS) use to ascertain validity of self-reported ATS use among young female sex workers in Cambodia

Addiction Science & Clinical Practice ◽

10.1186/1940-0640-7-11 ◽

2012 ◽

Vol 7 (1) ◽

pp. 11 ◽

Cited By ~ 9

Author(s):

Vannda Kab ◽

Jennifer Evans ◽

Neth Sansothy ◽

Ellen Stein ◽

Marie Claude-Couture ◽

...

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

Young Female ◽

Female Sex

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Correlates of HIV prevalence among female sex workers in four north and east Indian states: findings of a national bio-behavioural survey

International Journal of STD & AIDS ◽

10.1177/0956462418799018 ◽

2018 ◽

Vol 30 (2) ◽

pp. 120-130 ◽

Cited By ~ 1

Author(s):

Gunjika Misra ◽

Damodar Sahu ◽

Umenthala S Reddy ◽

Saritha Nair

Keyword(s):

Sex Work ◽

Sex Workers ◽

Female Sex Workers ◽

Uttar Pradesh ◽

Hiv Prevalence ◽

Indian States ◽

Factors Affecting ◽

East Indian ◽

Female Sex ◽

Behavioural Surveillance

The socio-demographic, sex work characteristics and the factors affecting HIV prevalence among female sex workers (FSWs) are not well known in low prevalence states showing rising trends within the HIV epidemic. This paper studies these attributes among FSWs in three north (Punjab, Rajasthan and Uttar Pradesh) and one east Indian states (Jharkhand). Integrated Biological and Behavioural Surveillance (IBBS) data, collected from 4491 FSWs in the study states, were analysed, with HIV status as the dependent variable and several socio-demographic, sex work, knowledge and agency characteristics as independent variables. Multivariate analysis found a number of factors such as age above 25 years (adjusted odds ratio [AOR] 5.0, 95% confidence interval [CI] 1.4–18.1), client solicitation in rented rooms (AOR 2.8, 95% CI 1.2–6.4) and the use of mobile phones for client solicitation (AOR 5.1, 95% CI 1.6–16.0) to be significantly associated with HIV risk. The study found low levels of HIV programme services uptake and HIV/AIDS knowledge among FSWs in the study states. There is an urgent need to focus on these risk factors for improving the effectiveness of the ongoing HIV prevention efforts and attaining the ‘Sustainable Development Goals’ goal of ‘Ending the AIDS epidemic’ by 2030.

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Characterizing Multi-level Determinants of HIV Prevalence Among Female Sex Workers in Maseru and Maputsoe, Lesotho

AIDS and Behavior ◽

10.1007/s10461-019-02495-8 ◽

2019 ◽

Vol 24 (3) ◽

pp. 714-723 ◽

Cited By ~ 1

Author(s):

Mitra Moazzami ◽

Sosthenes Ketende ◽

Carrie Lyons ◽

Amrita Rao ◽

Noah Taruberekera ◽

...

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

Hiv Prevalence ◽

Female Sex ◽

Multi Level

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Association Between System Reach and Exposure to Interventions and Characteristics of Mobile Female Sex Workers in Four High HIV Prevalence States in India

Global Journal of Health Science ◽

10.5539/gjhs.v7n4p83 ◽

2015 ◽

Vol 7 (4) ◽

Cited By ~ 1

Author(s):

Varun Sharma ◽

Niranjan Saggurti ◽

Shalini Bharat

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

Hiv Prevalence ◽

Female Sex

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Prevalence and incidence of HIV among female sex workers and their clients: modelling the potential effects of intervention in Rwanda

BMJ Global Health ◽

10.1136/bmjgh-2020-002300 ◽

2020 ◽

Vol 5 (8) ◽

pp. e002300

Author(s):

Sabin Nsanzimana ◽

Edward J Mills ◽

Ofir Harari ◽

Placidie Mugwaneza ◽

Etienne Karita ◽

...

Keyword(s):

General Population ◽

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

Hiv Prevalence ◽

Consistent Condom ◽

People Living With Hiv ◽

Hiv Incidence ◽

Female Sex ◽

Hiv Epidemic

BackgroundRwanda has identified several targeted HIV prevention strategies, such as promotion of condom use and provision of antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) for female sex workers (FSWs). Given this country’s limited resources, understanding how the HIV epidemic will be affected by these strategies is crucial.MethodsWe developed a Markov model to estimate the effects of targeted strategies to FSWs on the HIV prevalence/incidence in Rwanda from 2017 to 2027. Our model consists of the six states: HIV-; HIV+ undiagnosed/diagnosed pre-ART; HIV+ diagnosed with/without ART; and death. We considered three populations: FSWs, sex clients and the general population. For the period 2017–2027, the HIV epidemic among each of these population was estimated using Rwanda’s demographic, sexual risk behaviour and HIV-associated morbidity and mortality data.ResultsBetween 2017 and 2027, with no changes in the current condom and ART use, the overall number of people living with HIV is expected to increase from 344,971 to 402,451. HIV incidence will also decrease from 1.36 to 1.20 100 person-years. By 2027, a 30% improvement in consistent condom use among FSWs will result in absolute reduction of HIV prevalence among FSWs, sex clients and the general population by 7.86%, 5.97% and 0.17%, respectively. While recurring HIV testing and improving the ART coverage mildly reduced the prevalence/incidence among FSWs and sex clients, worsening the two (shown by our worst-case scenario) will result in an increase in the HIV prevalence/incidence among FSWs and sex clients. Introduction of PrEP to FSWs in 2019 will reduce the HIV incidence among FSWs by 1.28%.ConclusionsContinued efforts toward improving condom and ART use will be critical for Rwanda to continue their HIV epidemic control. Implementing a targeted intervention strategy in PrEP for FSWs will reduce the HIV epidemic in this high-risk population.

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