scholarly journals Do female sex workers have lower uptake of HIV treatment services than non-sex workers? A cross-sectional study from east Zimbabwe

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018751 ◽  
Author(s):  
Rebecca Rhead ◽  
Jocelyn Elmes ◽  
Eloghene Otobo ◽  
Kundai Nhongo ◽  
Albert Takaruza ◽  
...  

ObjectiveGlobally, HIV disproportionately affects female sex workers (FSWs) yet HIV treatment coverage is suboptimal. To improve uptake of HIV services by FSWs, it is important to identify potential inequalities in access and use of care and their determinants. Our aim is to investigate HIV treatment cascades for FSWs and non-sex workers (NSWs) in Manicaland province, Zimbabwe, and to examine the socio-demographic characteristics and intermediate determinants that might explain differences in service uptake.MethodsData from a household survey conducted in 2009–2011 and a parallel snowball sample survey of FSWs were matched using probability methods to reduce under-reporting of FSWs. HIV treatment cascades were constructed and compared for FSWs (n=174) and NSWs (n=2555). Determinants of service uptake were identified a priori in a theoretical framework and tested using logistic regression.ResultsHIV prevalence was higher in FSWs than in NSWs (52.6% vs 19.8%; age-adjusted OR (AOR) 4.0; 95% CI 2.9 to 5.5). In HIV-positive women, FSWs were more likely to have been diagnosed (58.2% vs 42.6%; AOR 1.62; 1.02–2.59) and HIV-diagnosed FSWs were more likely to initiate ART (84.9% vs 64.0%; AOR 2.33; 1.03–5.28). No difference was found for antiretroviral treatment (ART) adherence (91.1% vs 90.5%; P=0.9). FSWs’ greater uptake of HIV treatment services became non-significant after adjusting for intermediate factors including HIV knowledge and risk perception, travel time to services, physical and mental health, and recent pregnancy.ConclusionFSWs are more likely to take up testing and treatment services and were closer to achieving optimal outcomes along the cascade compared with NSWs. However, ART coverage was low in all women at the time of the survey. FSWs’ need for, knowledge of and proximity to HIV testing and treatment facilities appear to increase uptake.

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Khodabakhsh Ahmadi ◽  
Majid Rezazade ◽  
Mohammad Nafarie ◽  
Babak Moazen ◽  
Mosaieb Yarmohmmadi Vasel ◽  
...  

Purpose. To assess the prevalence and associated factors of unprotected sex with injecting drug users (IDUs) among a sample of female sex workers (FSWs) in Iran.Methods. This cross-sectional study included 144 FSWs who were interviewed as a part of Unhide HIV Risk Study, a national behavioral survey focusing on various high-risk populations, including IDUs, FSWs, and Men who have Sex with Men (MSMs) in 2009. The survey was conducted in eight provinces in Iran using respondent-driven sampling. Participants’ sociodemographic status, HIV knowledge, and HIV attitude were analyzed via logistic regression to determine the predictors of unprotected sex with IDU(s) during the past month.Results. Nineteen percent of FSWs reported at least one occasion of unprotected sex with IDU(s) in the month preceding the study. Higher educational level (OR=−0.653, 95%CI=-1.192to −0.115), perceived HIV risk (OR=−1.047, 95%CI=-2.076to −0.019), and perceived family intimacy during childhood (OR=−1.104, 95%CI=-1.957to −0.251) were all independently associated with lower odds of having unprotected sex with IDU(s) in the month preceding the study. Age, marital status, living condition, HIV knowledge, and perceived behavioral control did not affect the odds of FSWs having sex with IDUs.Conclusion. Perceived HIV risk, which is a modifiable factor, seems to be a promising target for harm reduction interventions amongst Iranian female sex workers. Data presented here may aid in reducing or eliminating the role of sex workers as a bridge for HIV transmission from IDUs to the general population in Iran.


2018 ◽  
Vol 29 (13) ◽  
pp. 1316-1323 ◽  
Author(s):  
Mwumvaneza Mutagoma ◽  
Laetitia Nyirazinyoye ◽  
Dieudonné Sebuhoro ◽  
David J Riedel ◽  
Joseph Ntaganira

Female sex workers (FSWs) are at high risk for HIV. Cross-sectional surveys using a venue–day–time approach for recruitment were conducted among FSWs in Rwanda in 2006, 2010 and 2015. Chi square test for trends was computed to determine behavior changes. Logistic regression models were computed to determine risk factors associated with consistent condom use for the 2015 survey. There were 1041, 1338, and 1978 FSWs surveyed in 2006, 2010, and 2015, respectively. Condom use at the last sexual encounter with a client was similar in all surveys: 84.2%, 64.1%, and 83.3% (p = 1.0), respectively. Comprehensive HIV knowledge among FSWs was higher in 2015 than in 2006: 18.4%, 53.1%, and 71.1% (p = 0.00), respectively. Living in Kigali City and the Western province (aOR = 1.9 [95% CI: 1.3–2.8] and aOR = 2.0 [95% CI: 1.4–2.9], respectively) and higher level of education (OR = 2.0 [95% CI: 1.4–2.9]) were positively associated with consistent condom use with a client. Street-based FSWs (aOR = 0.7 [95% CI: 0.6–0.9]); FSWs with sex work as sole occupation (aOR = 0.6 [95% CI: 0.5–0.7]); FSWs who experienced sexually transmitted infections in the last year (aOR = 0.7 [95% CI: 0.5–0.8]) and HIV-positive FSWs (aOR = 0.8 [95% CI: 0.6–0.9]) were less likely to report consistent condom use. HIV prevention methods have evolved among FSWs in RWanda over the last decade, but HIV prevalence remains high. Condom use among many FSWs is inconsistent. New approaches for behavior change and income-generating activities are needed to reduce the vulnerability of FSWs in Rwanda.


2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Sheree R. Schwartz ◽  
Erin Papworth ◽  
Odette Ky-Zerbo ◽  
Simplice Anato ◽  
Ashley Grosso ◽  
...  

Background. Reproductive health programming for female sex workers (FSW) may include contraceptive services but rarely addresses safer pregnancy planning.Methods. Adult FSW were enrolled into a cross-sectional study across four sites in Burkina Faso and Togo using respondent-driven sampling. Sociobehavioral questionnaires and HIV counseling and testing were administered. Sample statistics and engagement in HIV treatment were described and compared using Chi-squared statistics.Results. 1,349 reproductive-aged FSW were enrolled from January to July 2013. Overall, 267 FSW (19.8%) were currently trying to conceive. FSW trying to conceive were more likely to test positive for HIV at enrollment as compared to women not trying to become pregnant (24.5% versus 17.7%,P<0.01); however awareness of HIV status was similar across groups. Among FSW trying to conceive, 79.0% (211/267) had previously received HIV testing, yet only 33.8% (23/68) of HIV-infected FSW reported a previous HIV diagnosis. Overall 25.0% (17/68) of HIV-infected FSW trying to conceive were on antiretroviral therapy.Conclusion. FSW frequently desire children. However engagement in the HIV prevention and treatment cascade among FSW trying to conceive is poor potentiating periconception transmission risks to partners and infants. Programs to facilitate earlier HIV diagnosis for FSW and safer conception counseling are needed as components of effective combination HIV prevention services.


2021 ◽  
pp. 100012
Author(s):  
Rachel Jewkes ◽  
Kennedy Otwombe ◽  
Kristin Dunkle ◽  
Minja Milovanovic ◽  
Khuthadzo Hlongwane ◽  
...  

BMJ Open ◽  
2016 ◽  
Vol 6 (5) ◽  
pp. e009774
Author(s):  
Marianne Legendre-Dugal ◽  
Janet Bradley ◽  
Subramanian Potty Rajaram ◽  
Catherine M Lowndes ◽  
Banadakoppa M Ramesh ◽  
...  

2016 ◽  
Vol 92 (8) ◽  
pp. 593-598 ◽  
Author(s):  
Angela M Parcesepe ◽  
Kelly L L'Engle ◽  
Sandra L Martin ◽  
Sherri Green ◽  
Chirayath Suchindran ◽  
...  

2015 ◽  
Vol 05 (03) ◽  
pp. 85-91
Author(s):  
Damodar Sahu ◽  
Sowmya Ramesh ◽  
Ram Manohar Mishra ◽  
K. Srikanth Reddy ◽  
Reena Bharadwaj ◽  
...  

2018 ◽  
Vol 68 ◽  
pp. 01024
Author(s):  
Masayu Gemala Rabiah ◽  
Rini Mutahar ◽  
Rico Januar Sitorus

Chlamydia infection is one of the most common sexually transmitted infections worldwide. Based on data of IBBS 2015 in Indonesia, the highest prevalence of chlamydia occurred in direct female sex worker group (32.21%). This study a STIs to determine the risk factors for chlamydia infection in direct sex workers. This research uses Cross-Sectional study design. The population of this study were all direct female sex workers as many as 3,789 people with samples in accordance with inclusion and exclusion criteria as many as 3.114 people. The prevalence of direct female sex workers with chlamydia infection was 1.018 (32.4%). The result of the analysis showed that there was a relationship between age (PR: 0.541 95% CI: 0.456-0.643) and length of work as FDSW (PR: 1,.60, 95% CI: 1.087-1.512) chlamydia infection in female sex workers in Indonesia. most dominant variable has an effect on the incidence of chlamydia infection that is long working as FDSW after controlled by age (PR 1.282 95% CI: 1.087-1,.12). It is expected for the government to improve the implementation of prevention program of chlamydia not only among female sex worker but also proactive to customer.


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