Trends in HIV Prevalence, Condom Use and Associated Factors among Female Sex Workers in Denpasar, Bali, Indonesia

Objectives: The purpose of this paper is to review trends of HIV prevalence, condom use and associated risk factors among the female sex workers (FSW) in Denpasar, Bali. Methods: To analyze trends of HIV prevalence, surveillance data from 2000-2013 was used. Survey data from 2007 to 2013 was referenced for analysis of condom use trends. Data on associated risk factors was taken from 2012 integrated HIV and behavior survey. Results and conclusion: HIV prevalence among direct FSW in 2000 was as low as 1.6% (95%CI: 0.05-3.15) and continued to rise, reaching a prevalence peak of 22.5% (95%CI: 16.4-26.6) in 2010. HIV prevalence began to decline in 2011, 2012 and 2013. Analysis unearthed similar prevalence trends among indirect FSW albeit with a much lower prevalence of 0.25% in 2001, rising to 7.2% in 2010 and declining to 2.2% in 2013. The proportion of direct FSW reporting to always wear condoms in the last working week increased from 38% in 2007 (95%CI: 33.3-42.7) to 65% in 2013 (95%CI: 60.4-69.6). Multivariate analysis with logistic regression indicated that the significant risk factor with HIV prevalence was the specific grouping of FSW, in that low/mid-price are more at risk in comparison to high price with OR=4.37 (95%CI: 1.42-13.38). Risk factors associated with condom use was also the specific group of FSW, high price reported higher condom use with OR=4.04 (95%CI:2.03-8.04) and greater role of sex work site ‘pimps’ in encouraging their FSW to reject clients refusing to wear condoms with OR=2.06 (95%CI: 1.29-3.30). HIV prevalence among indirect and high-price direct FSW was much lower compared to prevalence in low/mid-price direct FSW. HIV prevalence and condom use among direct FSW population are significantly associated with group price range and the role of ‘pimps’.

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A DEMOGRAPHIC AND HEALTH SURVEY OF SPANISH FEMALE SEX WORKERS: HIV PREVALENCE AND ASSOCIATED RISK FACTORS

Journal of Biosocial Science ◽

10.1017/s0021932098003654 ◽

1998 ◽

Vol 30 (3) ◽

pp. 365-379 ◽

Cited By ~ 10

Author(s):

PILAR ESTÉBANEZ ◽

MA. VICTORIA ZUNZUNEGUI ◽

MA. DOLORES AGUILAR ◽

CONCHA COLOMA ◽

MILAGROSA RUA‐FIGUEROA ◽

...

Keyword(s):

Risk Factors ◽

Health Survey ◽

Sex Workers ◽

Female Sex Workers ◽

Hiv Prevalence ◽

Demographic And Health Survey ◽

Female Sex ◽

Associated Risk Factors

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HIV Incidence and Associated Risk Factors Among Female Sex Workers in a High HIV-Prevalence Area of China

Sexually Transmitted Diseases ◽

10.1097/olq.0b013e318266b241 ◽

2012 ◽

Vol 39 (11) ◽

pp. 835-841 ◽

Cited By ~ 16

Author(s):

Haibo Wang ◽

Kathleen H. Reilly ◽

Katherine Brown ◽

Xia Jin ◽

Junjie Xu ◽

...

Keyword(s):

Risk Factors ◽

Sex Workers ◽

Female Sex Workers ◽

Hiv Prevalence ◽

Hiv Incidence ◽

Female Sex ◽

Associated Risk Factors

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Neisseria gonorrhoeae prevalence, incidence and associated risk factors among female sex workers in a high HIV-prevalence area of China

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2015.07.025 ◽

2015 ◽

Vol 38 ◽

pp. 115-120 ◽

Cited By ~ 2

Author(s):

Li Luo ◽

Xin Li ◽

Lu-lu Zhang

Keyword(s):

Risk Factors ◽

Neisseria Gonorrhoeae ◽

Sex Workers ◽

Female Sex Workers ◽

Hiv Prevalence ◽

Female Sex ◽

Associated Risk Factors

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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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Mobile phones and sex work in South India: the emerging role of mobile phones in condom use by female sex workers in two Indian states

Culture Health & Sexuality ◽

10.1080/13691058.2014.960002 ◽

2014 ◽

Vol 17 (2) ◽

pp. 252-265 ◽

Cited By ~ 8

Author(s):

Sonia Navani-Vazirani ◽

Davidson Solomon ◽

Gopalakrishnan ◽

Elsa Heylen ◽

Aylur Kailasom Srikrishnan ◽

...

Keyword(s):

Condom Use ◽

Sex Work ◽

Mobile Phones ◽

Sex Workers ◽

Female Sex Workers ◽

South India ◽

Indian States ◽

Female Sex

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HIV AND OTHER SEXUALLY TRANSMITTED INFECTIONS AMONG FEMALE SEX WORKERS IN MOSCOW (RUSSIA) SCIENTIFIC REPORT PREVALENCE AND ASSOCIATED RISK FACTORS

Human Rights Documents Online ◽

10.1163/2210-7975_hrd-5548-20190005 ◽

2020 ◽

Keyword(s):

Risk Factors ◽

Sexually Transmitted Infections ◽

Sex Workers ◽

Female Sex Workers ◽

Sexually Transmitted ◽

Female Sex ◽

Scientific Report ◽

Associated Risk Factors

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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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High HIV prevalence and associated risk factors among female sex workers in Rwanda

International Journal of STD & AIDS ◽

10.1177/0956462416688137 ◽

2017 ◽

Vol 28 (11) ◽

pp. 1082-1089 ◽

Cited By ~ 9

Author(s):

Mwumvaneza Mutagoma ◽

Malamba S Samuel ◽

Catherine Kayitesi ◽

Antoine R Gasasira ◽

Bassirou Chitou ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Hiv Infection ◽

Sex Workers ◽

Female Sex Workers ◽

Hiv Prevalence ◽

Consistent Condom ◽

Prevention Strategies ◽

Consistent Condom Use ◽

Associated Risk Factors

Human immunodeficiency virus (HIV) prevalence is often high among female sex workers (FSWs) in sub-Saharan Africa. Understanding the dynamics of HIV infection in this key population is critical to developing appropriate prevention strategies. We aimed to describe the prevalence and associated risk factors among a sample of FSWs in Rwanda from a survey conducted in 2010. A cross-sectional biological and behavioral survey was conducted among FSWs in Rwanda. Time–location sampling was used for participant recruitment from 4 to 18 February 2010. HIV testing was done using HIV rapid diagnostic tests (RDT) as per Rwandan national guidelines at the time of the survey. Elisa tests were simultaneously done on all samples tested HIV-positive on RDT. Proportions were used for sample description; multivariable logistic regression model was performed to analyze factors associated with HIV infection. Of 1338 women included in the study, 1112 consented to HIV testing, and the overall HIV prevalence was 51.0%. Sixty percent had been engaged in sex work for less than five years and 80% were street based. In multivariable logistic regression, HIV prevalence was higher in FSWs 25 years or older (adjusted odds ratio [aOR] = 1.83, 95% [confidence interval (CI): 1.42–2.37]), FSWs with consistent condom use in the last 30 days (aOR = 1.39, [95% CI: 1.05–1.82]), and FSWs experiencing at least one STI symptom in the last 12 months (aOR = 1.74 [95% CI: 1.34–2.26]). There was an inverse relationship between HIV prevalence and comprehensive HIV knowledge (aOR = 0.65, [95% CI: 0.48–0.88]). HIV prevalence was high among a sample of FSWs in Rwanda, and successful prevention strategies should focus on HIV education, treatment of sexually transmitted infections, and proper and consistent condom use using an outreach approach.

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