Association between HIV1 infection and sexually transmitted disease among men in central Africa

Martin, Paul; Grésenguet, Gérard; Massanga, M; Georges, A. J.; Testa, J.

doi:10.1016/s0923-2516(06)80105-6

Cited by 7 publications

(6 citation statements)

References 15 publications

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“…Those characteristics which were categorised as pertaining to individual behaviour were the most important in the association, both in the bi-variate and in the multi-variate analyses. Previous studies addressing behavioural characteristics as risk factors have revealed similar patlerns of associations (Hrdy, 1987;Berkley et al, 1989;Cameron et al, 1989;Wasser et al, 1989;Mhalu, 1990;Nsubuga et al, 1990;Martin et al, 1992;Chetwynd et al, 1993). The findings also show that urban residence, perceived inadequacy of knowledge and disrupted or multiple marriage were associated with HIV-I infection.…”

Section: Discussionsupporting

confidence: 66%

Communicating with the people about HIV infection risk as a basis for planning interventions: Lessons from the Kagera region of Tanzania

Killewo

Sandström

Dahlgren

et al. 1997

Social Science & Medicine

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Section: Discussionsupporting

confidence: 66%

Communicating with the people about HIV infection risk as a basis for planning interventions: Lessons from the Kagera region of Tanzania

Killewo

Sandström

Dahlgren

et al. 1997

Social Science & Medicine

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“…This observation is reminiscent of numerous previous reports demonstrating that STIs act as a major cofactor of HIV acquisition in sub-Saharan Africa [ 30 ]. The strong association between HIV infection and STIs is also well known in the CAR [ 5 ]. The difficulties encountered by FSW in accessing health facilities and adequate information on HIV and STIs expose a vicious cycle of HIV and STIs, and favor the risk of STIs with further HIV acquisition [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, the association was not retained in multivariate analysis, likely because of insufficient number of enrolled participants. High rates of positive syphilis and HSV-2 serologies were previously reported in FSW [ 11 , 22 , 45 – 49 ], and are considered as classical risk factors for HIV acquisition in sub-Saharan Africa [ 5 , 6 , 10 , 17 , 30 , 50 ]. Bacterial vaginosis was frequent in study FSW.…”

Section: Discussionmentioning

confidence: 99%

“…The HIV epidemic in the CAR depicts a trend towards feminization, with an HIV prevalence among women (7.8%) double the prevalence among men (4.3%) in the same age group [ 1 ]. The dynamic of HIV epidemic in heterosexual population is particularly affected by the serial or concomitant occurrence of sexually transmitted infections (STIs) [ 5 – 7 ]. A strong synergistic association between heterosexual transmission and acquisition of HIV and genital herpes simplex virus type 2 (HSV-2) infection was demonstrated in sexually active adults [ 6 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for HIV infection among female sex workers in Bangui, Central African Republic

et al. 2017

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ObjectiveThe aims of the study were i) to categorize female sex workers (FSW) according to socio-anthropologic criteria in Bangui; ii) to examine the association between a selection of demographic and risk variables with the different categories of female sex work as outcome, and iii) to investigate factors associated with HIV status.MethodsA cross-sectional questionnaire survey was conducted to describe the spectrum of commercial sex work in Bangui among 345 sexually active women. After collection of social and behavioral characteristics, each woman received a physical examination and a blood sample was taken for biological analyses, including HIV testing. The relationships between sociodemographic characteristics, behavioral variables involved in high risk for HIV as well as biological results were investigated by bivariate analysis in relationship with FSW categories as main outcomes, and by bivariate analysis followed by multivariate logistic regression analysis in relationship with HIV as the main outcome. The strength of statistical associations was measured by crude and adjusted Odds ratios (OR) and their 95% confidence intervals.ResultsThe typology of FSW comprised six different categories. Two groups were the “official” professional FSW primarily classified according to their locations of work [i) “kata“(18.55%) representing women working in poor neighborhoods of Bangui; ii) “pupulenge” (13.91%) working in hotels and night clubs to seek white men]. Four groups were “clandestine” nonprofessional FSW classified according to their reported main activity [i) “market and street vendors” (20.86%); ii) “schoolgirls or students” (19.13%) involved in occasional transactional sex (during holidays); iii) “housewives or unemployed women” (15.65%); iv) “civil servants” (11.88%) working as soldiers or in the public sector]. The overall prevalence of HIV-1 was 19.12% (66/345). HIV varied according to FSW categories. Thus, among professional FSW, the HIV prevalence was 6-fold higher in "kata" than "pupulenge" (39.13% versus 6.30%; P = 0.001). Among nonprofessional FSW, the "vendors" showed the highest HIV prevalence (31.91%), which was higher than in "students" (6.10%; P = 0.001), "civil servants" (9.83%; P = 0.005), and "housewives" (13.00%; P = 0.01). In bivariate analysis, the following variables showed statistically significant association with risk for HIV infection: nationality; age of first sexual intercourse; self-assessment of HIV risk; knowledge of HIV status; anal sex practice with last clients; irregular condom use in last week; consumption of alcohol; other psycho-active substances; past history of STIs; HBs Ag; HSV-2 and bacterial vaginosis. However, the variable “sex workers categories” dichotomized into professional versus nonprofessional FSW was no longer associated with HIV. In multivariate logistical regression analysis, HIV infection was strongly associated with nationality (15.65% versus 3.77%) [adjusted OR (aOR) 3.39: 95% CI:1.25–9.16, P<0.05]; age of first sexual intercourse (21.10% versus 14.00%)...

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“…The human immunodeficiency virus (HIV) epidemic in the Central African Republic (CAR) is widespread and generalized with an overall prevalence of 4.6% throughout the country in 2011, and 6.2%, among women of childbearing age in Bangui (UNFPA, 2012 ; UNICEF, 2011 ). The principal mode of transmission is heterosexual intercourse (UNAIDS, 2012 ), with sexually transmitted infections (STIs) acting as major modulatory cofactors (Blankhart, Müller, Gresenguet, & Weis, 1999 ; Gresenguet, Belec, Martin, & Georges, 1991 ; Grésenguet et al, 2002 ; Martin P.M. et al, 1992 ; Mbopi-Kéou et al, 2000 ). Specifically, a strong synergistic association between heterosexual transmission and acquisition of HIV and genital herpes type 2 has been demonstrated in sexually active adults (LeGoff et al, 2007 ; Mbopi-Kéou et al, 2000 ).…”

Section: Introductionmentioning

confidence: 99%

Spectrum of female commercial sex work in Bangui, Central African Republic

Longo

Simaléko

Ngbale

et al. 2017

SAHARA-J: Journal of Social Aspects of HIV/AIDS

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Classification of professional and non-professional female sex workers (FSWs) into different categories, never previously reported in the Central African Republic (CAR), may be useful to assess the dynamics of the human immunodeficiency virus (HIV) epidemic, design operational intervention programmes to combat HIV and other sexually transmitted infections (STIs) and to adapt these programmes to the broad spectrum of sexual transactions in the CAR. Our study proposes a socio-behavioural classification of FSWs living in the CAR and engaged in transactional and commercial sex. Thus, the aims of the study were these: (i) to categorize FSWs according to socio-anthropologic criteria in Bangui and (ii) to examine the association between a selection of demographic and risk variables with the different categories of female sex work as an outcome. A cross-sectional questionnaire survey was conducted in 2013 to describe the spectrum of commercial sex work (CSW) in Bangui among 345 sexually active women having more than 2 sexual partners, other than their regular partner, during the prior 3 months and reporting to have received money or gifts in return for their sexual relationships. According to socio-behavioural characteristics, FSWs were classified into six different categories. Professional FSWs, constituting 32.5% of the interviewed women, were divided in two categories: pupulenge (13.9%), i.e., dragonflies (sometimes called gba moundjou, meaning literally look at the White) consisting of roamers, who travel around the city to hotels and nightclubs seeking wealthy clients, with a preference for French men; and the category of kata (18.6%), i.e., FSWs working in poor neighbourhoods. Non-professional FSWs, constituting 67.5% of the interviewed women, were divided into four categories: street and market vendors (20.8%), students (19.1%), housewives (15.7%) and unskilled civil servants (11.9%). In general, CSW in the CAR presents a remarkably heterogeneous phenomenon. Risk-taking behaviour regarding STI/HIV infection appears to be different according to the different categories of female CSW. The groups of katas and street vendors were poorer and less educated, consumed more alcohol or other psycho-active substances (cannabis, tramadol and glue) and, consequently, were more exposed to STI. Our results emphasise the high level of vulnerability of both poor professional FSWs (kata) and non-professional sex workers, especially street vendors, who should be taken into account when designing prevention programmes targeting this population for STI/HIV control purposes.

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Association between HIV1 infection and sexually transmitted disease among men in central Africa

Cited by 7 publications

References 15 publications

Communicating with the people about HIV infection risk as a basis for planning interventions: Lessons from the Kagera region of Tanzania

Communicating with the people about HIV infection risk as a basis for planning interventions: Lessons from the Kagera region of Tanzania

Risk factors for HIV infection among female sex workers in Bangui, Central African Republic

Spectrum of female commercial sex work in Bangui, Central African Republic

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