A cross-sectional evaluation of the prevalence and associations of HIV among female sex workers in the Gambia

Abstract

To determine HIV prevalence among female sex workers in the Gambia and HIV risk factors, we accrued participants (n = 251) through peer-referral and venue-based recruitment. Blood samples were screened for HIV and participants were administered a questionnaire. Bivariate and multivariate logistic regression identified factors associated with HIV status. Forty respondents (15.9%) were HIV-positive: 20 (8.0%) were infected with HIV-1 only, 10 (4.0%) with HIV-2 only, and 10 (4.0%) with both HIV-1 and HIV-2; 12.5% (n = 5/40) knew their status. Condom usage at last sex was 97.1% (n = 170/175) with new clients and 44.2% (n = 53/120) with non-paying partners. Having a non-paying partner, living with relatives or friends, having felt scared to walk in public, selling sex in multiple locations, and recent depressive symptoms were positively associated with HIV under multivariate regression. Female sex workers have a higher prevalence of HIV compared to the general Gambian population. Interventions should be rights-based, promote safer sex practices and regular testing for female sex workers and linkage to HIV treatment and care with adherence support for those living with HIV. In addition, service providers should consider non-paying partners of female sex workers, improve knowledge and availability of condoms and lubricant, and address safety and mental health needs.

Socioecological Factors Related to Hazardous Alcohol use among Female Sex Workers in Lilongwe, Malawi: A Mixed Methods Study

“…This study was a descriptive, cross-sectional biological and behavioral study among FSW in Lilongwe, Malawi. From July through September 2014, we systematically recruited FSW using venue-based sampling at venues where FSW are known to solicit sex (Johnston, Sabin, Mai, & Pham, 2006; Peitzmeier et al, 2014). Our outreach team comprised HIV testing counselors, interviewers, a study nurse, a driver for the mobile clinic, and a peer FSW to facilitate approaching women at the venues.…”

Substance use and HIV infection awareness among HIV-infected female sex workers in Lilongwe, Malawi

“…We employed a cross-sectional design to systematically recruit FSW using venue-based sampling, a strategy with documented success in identifying hidden populations, such as FSW. 47–51 We recruited FSW using a mobile van and an outreach team comprising a peer FSW, HIV testing counselors, interviewers, a study nurse, and a driver. The mobile van was operated by TfaC and in addition to contributing to study specific activities, TfaC staff provided group sexual risk reduction and family planning counseling at the venue after study activities were completed.…”

HIV epidemic among key populations in west Africa

“…A meta-analysis of FSW studies in low to middle-income countries indicated that FSW in sub-Saharan Africa had 12.4 times the odds of HIV compared with all women of reproductive age [15 ▪▪ ]. HIV prevalence in FSW varies within and across west African settings, with reported estimates over the past 5 years of 15.9% in The Gambia [22], 20% in Nigeria [23], 20.1% in Senegal [21], 25.7% in Bobo-Dioulasso, Burkina Faso [24], 26.6% in Côte d’Ivoire [17], 30.4% in Cotonou, Benin [25], 45.4% in Lome, Togo [20] and up to 68.6% in a study in Ghana and Benin [18] (Table 1). Although data are scarce for male and transgender sex workers, a study conducted among male sex workers in Côte d’Ivoire identified an HIV prevalence of 50% [7].…”