Interventions among male clients of female sex workers in Benin, West Africa: an essential component of targeted HIV preventive interventions

Lowndes, Catherine M; Alary, Michel; Labbé, Annie‐Claude; Gnintoungbé, C A B; Belleau, Michelyne; Mukenge, Leonard; Meda, Honoré A.; Ndour, Marguerite; Anagonou, S.; Gbaguidi, Alphonse

doi:10.1136/sti.2007.027441

Cited by 73 publications

(59 citation statements)

References 17 publications

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“…Further, most (70%) boyfriends of FSW in a study in Guinea and Benin reported having been clients of one or more sex workers other than their girlfriends [1]. HIV prevalence among boyfriends of FSW has also been shown to be higher than that among FSW clients: twice as high in a study in Benin (16.1% among boyfriends versus 8.3% among clients) [103], and even higher in Ghana (32.1% among boyfriends versus 4.9% among clients of mobile sex workers and 15.8% among clients of home-based sex workers) [104]. These patterns suggest that sex work in sub-Saharan Africa cannot be viewed in isolation from HIV-risk behaviors in the general population, such as multiple concurrent partnerships.…”

Section: Unsafe Sexmentioning

confidence: 88%

Socio-Demographic Characteristics and Behavioral Risk Factors of Female Sex Workers in Sub-Saharan Africa: A Systematic Review

et al. 2011

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Sex work remains an important contributor to HIV transmission within early, advanced and regressing epidemics in sub-Saharan Africa, but its social and behavioral underpinnings remain poorly understood, limiting the impact of HIV prevention initiatives. This article systematically reviews the socio-demographics of female sex workers (FSW) in this region, their occupational contexts and key behavioral risk factors for HIV. In total 128 relevant articles were reviewed following a search of Medline, Web of Science and Anthropological Index. FSW commonly have limited economic options, many dependents, marital disruption, and low education. Their vulnerability to HIV, heightened among young women, is inextricably linked to the occupational contexts of their work, characterized most commonly by poverty, endemic violence, criminalization, high mobility and hazardous alcohol use. These, in turn, predict behaviors such as low condom use, anal sex and co-infection with other sexually transmitted infections. Sex work in Africa cannot be viewed in isolation from other HIV-risk behaviors such as multiple concurrent partnerships-there is often much overlap between sexual networks. High turn-over of FSW, with sex work duration typically around 3 years, further heightens risk of HIV acquisition and transmission. Targeted services at sufficiently high coverage, taking into account the behavioral and social vulnerabilities described here, are urgently required to address the disproportionate burden of HIV carried by FSW on the continent.

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Section: Unsafe Sexmentioning

confidence: 88%

Socio-Demographic Characteristics and Behavioral Risk Factors of Female Sex Workers in Sub-Saharan Africa: A Systematic Review

et al. 2011

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“…Our results, combined with the condom use rates reported in our literature review (KHPT and University of Manitoba 2008) thus reaffirm the relevance of continuing with condom-use promotion in South India. However, for this to reach its full potential, activities targeting the structural and cultural factors underlying the gender inequalities in relationships in South India should be developed and should take into account the complexities of the factors determining condom use (McMillan and Worth 2011), as well as the need to involve both female sex workers and their clients in interventions (Blankenship et al 2008;Lipovsek et al 2010;Lowndes et al 2007). …”

Section: Discussionmentioning

confidence: 99%

Gender relations and risks of HIV transmission in South India: the discourse of female sex workers' clients

Aubé-Maurice

Clément

Bradley

et al. 2012

Culture, Health & Sexuality

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In South India, where the majority of the country's cases of HIV are concentrated, transmission of infection occurs mainly within networks composed of female sex workers, their clients and the other sexual partners of the latter. This study aims to determine how gender relations affect the risks of HIV transmission in this region. Semi-structured interviews were carried out with 30 clients and analysed qualitatively. Results show that clients perceive sexual relations with female sex workers as a vice involving loss of control and contact with women at the bottom of the social ladder. Paradoxically, this sometimes allows them to conform to the masculine ideal, in giving sexual satisfaction to a woman, in a context of incompatibility between the idealised and actual masculine and feminine archetypes. Attitudes to condoms, affected by various facets of the client-female sex worker relationship, are indicators of the link between this relationship and the risks of contracting HIV. The results suggest that there is a need for expanding targeted HIV prevention towards clients and female sex workers alongside more general interventions on gender issues, particularly among young people, focusing on the structural elements moulding current relations between men and women, with particular consideration of local cultural characteristics.

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“…The Indian national response had variable, but in general, low coverage of core groups, namely female sex workers (FSW), high-risk men who have sex with men (MSM)/transgender individuals and injecting drug users (IDU) [21,29,30]. Globally, there was evidence that intervening with core and bridge groups in early and concentrated epidemics translated into HIV reduction among general populations [27,[31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]. At the time there were few examples of large-scale HIV prevention interventions [1,33,37,38,[46][47][48].…”

Section: Avahan the India Aids Initiativementioning

confidence: 99%

Evaluation design for large-scale HIV prevention programmes: the case of Avahan, the India AIDS initiative

Chandrasekaran¹,

Dallabetta²,

Loo³

et al. 2008

Aids

112

114

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Interventions among male clients of female sex workers in Benin, West Africa: an essential component of targeted HIV preventive interventions

Cited by 73 publications

References 17 publications

Socio-Demographic Characteristics and Behavioral Risk Factors of Female Sex Workers in Sub-Saharan Africa: A Systematic Review

Socio-Demographic Characteristics and Behavioral Risk Factors of Female Sex Workers in Sub-Saharan Africa: A Systematic Review

Gender relations and risks of HIV transmission in South India: the discourse of female sex workers' clients

Evaluation design for large-scale HIV prevention programmes: the case of Avahan, the India AIDS initiative

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