Condom use, intervention service utilization and HIV knowledge among female sex workers in China: results of three consecutive cross-sectional surveys in Shandong Province with historically low HIV prevalence

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.

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Association between treatment for gonorrhoea and chlamydia and lower condom use in a cross-sectional study of female sex workers in southern India

BMJ Open ◽

10.1136/bmjopen-2015-009774 ◽

2016 ◽

Vol 6 (5) ◽

pp. e009774

Author(s):

Marianne Legendre-Dugal ◽

Janet Bradley ◽

Subramanian Potty Rajaram ◽

Catherine M Lowndes ◽

Banadakoppa M Ramesh ◽

...

Keyword(s):

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Southern India ◽

Sectional Study ◽

Cross Sectional ◽

Female Sex

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Early sex work initiation and condom use among alcohol-using female sex workers in Mombasa, Kenya: a cross-sectional analysis

Sexually Transmitted Infections ◽

10.1136/sextrans-2016-052549 ◽

2016 ◽

Vol 92 (8) ◽

pp. 593-598 ◽

Cited By ~ 9

Author(s):

Angela M Parcesepe ◽

Kelly L L'Engle ◽

Sandra L Martin ◽

Sherri Green ◽

Chirayath Suchindran ◽

...

Keyword(s):

Condom Use ◽

Sex Work ◽

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional ◽

Female Sex ◽

Cross Sectional Analysis ◽

Sectional Analysis

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

BMJ Open ◽

10.1136/bmjopen-2017-018751 ◽

2018 ◽

Vol 8 (2) ◽

pp. e018751 ◽

Cited By ~ 3

Author(s):

Rebecca Rhead ◽

Jocelyn Elmes ◽

Eloghene Otobo ◽

Kundai Nhongo ◽

Albert Takaruza ◽

...

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

Household Survey ◽

Hiv Treatment ◽

Sample Survey ◽

Physical And Mental Health ◽

Hiv Knowledge ◽

Cross Sectional ◽

Female Sex ◽

Treatment Services

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.

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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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HIV prevalence among female sex workers in Guigang City, Guangxi, China: an 8-year consecutive cross-sectional study

BMC Public Health ◽

10.1186/s12889-018-5380-2 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 3

Author(s):

Jingzhen Lai ◽

Chunwei Qin ◽

Eric J. Nehl ◽

Junjun Jiang ◽

Yunxuan Huang ◽

...

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

Cross Sectional Study ◽

Hiv Prevalence ◽

Sectional Study ◽

Cross Sectional ◽

Female Sex

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HIV prevalence, AIDS knowledge, and condom use among female sex workers in Santiago, Chile

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2007000800004 ◽

2007 ◽

Vol 23 (8) ◽

pp. 1777-1784 ◽

Cited By ~ 15

Author(s):

Jaime E. Barrientos ◽

Michel Bozon ◽

Edith Ortiz ◽

Anabella Arredondo

Keyword(s):

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

Positive Impact ◽

Transmitted Disease ◽

Hiv Prevalence ◽

Consistent Condom ◽

Hiv Seroprevalence ◽

Female Sex ◽

Aids Knowledge

This paper describes HIV seroprevalence, knowledge of HIV transmission, and condom use among female sex workers (FSW) attending five specialized sexually transmitted disease (STD) clinics in Santiago, Chile. A short questionnaire with socio-demographic, AIDS knowledge, and condom-use variables was administered to 626 FSW. HIV seroprevalence was estimated with a blood test sent to the Chilean Public Health Institute. ELISA was used to confirm HIV in suspected cases. HIV prevalence was 0%. FSW showed adequate overall knowledge of HIV, even better than reported for the Chilean general population on some items. Condom use with clients was high ("always" = 93.4%), although regular use with steady partners was low ("always" = 9.9%). The zero HIV seroprevalence and consistent condom use with clients confirms the positive impact of intervention strategies for FSW, increasing both correct knowledge of AIDS and condom use with clients and helping decrease these women's HIV/AIDS vulnerability.

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Unprotected Sex with Injecting Drug Users among Iranian Female Sex Workers: Unhide HIV Risk Study

AIDS Research and Treatment ◽

10.1155/2012/651070 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 12

Author(s):

Khodabakhsh Ahmadi ◽

Majid Rezazade ◽

Mohammad Nafarie ◽

Babak Moazen ◽

Mosaieb Yarmohmmadi Vasel ◽

...

Keyword(s):

Hiv Risk ◽

Sex Workers ◽

Drug Users ◽

Female Sex Workers ◽

Injecting Drug Users ◽

Unprotected Sex ◽

Perceived Behavioral Control ◽

Hiv Knowledge ◽

Cross Sectional ◽

Female Sex

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.

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Determinants of HIV prevalence among female sex workers in four south Indian states: analysis of cross-sectional surveys in twenty-three districts

AIDS ◽

10.1097/01.aids.0000343762.54831.5c ◽

2008 ◽

Vol 22 (Suppl 5) ◽

pp. S35-S44 ◽

Cited By ~ 87

Author(s):

Banadakoppa M Ramesh ◽

Stephen Moses ◽

Reynold Washington ◽

Shajy Isac ◽

Bidhubhushan Mohapatra ◽

...

Keyword(s):

Sex Workers ◽

Female Sex Workers ◽

Hiv Prevalence ◽

Cross Sectional ◽

Indian States ◽

Female Sex ◽

South Indian

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Factors associated with inconsistent condom use with clients among female sex workers in Podgorica, Montenegro

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1608424l ◽

2016 ◽

Vol 144 (7-8) ◽

pp. 424-430

Author(s):

Dragan Lausevic ◽

Senad Begic ◽

Natasa Terzic ◽

Zoran Vratnica ◽

Alma Cicic ◽

...

Keyword(s):

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

Snowball Sampling ◽

Inconsistent Condom ◽

Cross Sectional ◽

Factors Associated ◽

Female Sex ◽

Increased Risk ◽

Inconsistent Condom Use

Introduction. Female sex workers (FSWs) are a group at increased risk for human immunodeficiency virus (HIV) infection, and inconsistent condom use with clients is a known risk factor for infection in this group. Objective. The aim of the study was to determine factors associated with inconsistent condom use with clients among female sex workers in Podgorica, Montenegro. Methods. We conducted an HIV bio-behavioral cross-sectional study in a sample of female sex workers recruited by snowball sampling. Results. A total of 142 FSWs were recruited. Eighty-one (57.0%) of them used condoms consistently with clients. HIV prevalence was 0.0%. In the multivariate analysis inconsistent condom use with clients in the previous month was associated with clients? negative personal attitude [age-adjusted odds ratio (AOR) = 22.7, 95% confidence interval (CI) = 2.3-228.0] or client?s indifference (AOR = 13.0, 95% CI = 1.4-118.9) towards using condom during sex with sexual workers, decision making by clients or by mutual agreement with client about using a condom (AOR = 10.2, 95% CI = 3.7-28.0), and early age of first sex (AOR = 5.4, 95% CI = 1.6-18.5). Conclusion. Our results suggest not only the need for further promotion of condom use, information and education for FSW but also the need to strengthen negotiation skills of FSWs with clients on regular use of condoms, as well as the need to extend prevention programs to clients of FSWs.

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