Mapping and size estimates of female sex workers in Cameroon: Toward informed policy for design and implementation in the national HIV program

Billong, Serge Clotaire; Nguefack‐Tsague, Georges; Fokam, Joseph; Emmanuel, Faran; Isac, Shajy; Fodjo, Raoul A. T.; Ngoufack, Marie Nicole; Kwedi, Sylvie; Moukam, Laure Vartan; Tchetmi, Thomas; Tapka, Vincent K.; Ndjolo, Alexis; Shubber, Zara; Cheikh, Nejma; Blanchard, James; Elat, Jean-Bosco Nfetam; Mziray, Elizabeth

doi:10.1371/journal.pone.0212315

Cited by 7 publications

(9 citation statements)

References 16 publications

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“…This is true even after adjusting for the population size in the local government area. This finding is consistent with key population hotspot mapping and size estimation exercises conducted previously in Nigeria and in other countries [34]. This finding is also consistent with the expectations and experiences among stakeholders in the country and previous studies conducted in Nigeria [21][22][23].…”

Section: Overview Of Our Findingssupporting

confidence: 92%

Key Population Hotspots in Nigeria for Targeted HIV Program Planning: Mapping, Validation, and Reconciliation

Lo¹,

Nwafor²,

Schwitters³

et al. 2021

JMIR Public Health Surveill

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Background With the fourth highest HIV burden globally, Nigeria is characterized as having a mixed HIV epidemic with high HIV prevalence among key populations, including female sex workers, men who have sex with men, and people who inject drugs. Reliable and accurate mapping of key population hotspots is necessary for strategic placement of services and allocation of limited resources for targeted interventions. Objective We aimed to map and develop a profile for the hotspots of female sex workers, men who have sex with men, and people who inject drugs in 7 states of Nigeria to inform HIV prevention and service programs and in preparation for a multiple-source capture-recapture population size estimation effort. Methods In August 2018, 261 trained data collectors from 36 key population–led community-based organizations mapped, validated, and profiled hotspots identified during the formative assessment in 7 priority states in Nigeria designated by the United States President’s Emergency Plan for AIDS Relief. Hotspots were defined as physical venues wherein key population members frequent to socialize, seek clients, or engage in key population–defining behaviors. Hotspots were visited by data collectors, and each hotspot’s name, local government area, address, type, geographic coordinates, peak times of activity, and estimated number of key population members was recorded. The number of key population hotspots per local government area was tabulated from the final list of hotspots. Results A total of 13,899 key population hotspots were identified and mapped in the 7 states, that is, 1297 in Akwa Ibom, 1714 in Benue, 2666 in Cross River, 2974 in Lagos, 1550 in Nasarawa, 2494 in Rivers, and 1204 in Federal Capital Territory. The most common hotspots were those frequented by female sex workers (9593/13,899, 69.0%), followed by people who inject drugs (2729/13,899, 19.6%) and men who have sex with men (1577/13,899, 11.3%). Although hotspots were identified in all local government areas visited, more hotspots were found in metropolitan local government areas and state capitals. Conclusions The number of key population hotspots identified in this study is more than that previously reported in similar studies in Nigeria. Close collaboration with key population–led community-based organizations facilitated identification of many new and previously undocumented key population hotspots in the 7 states. The smaller number of hotspots of men who have sex with men than that of female sex workers and that of people who inject drugs may reflect the social pressure and stigma faced by this population since the enforcement of the 2014 Same Sex Marriage (Prohibition) Act, which prohibits engaging in intimate same-sex relationships, organizing meetings of gays, or patronizing gay businesses.

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Section: Overview Of Our Findingssupporting

confidence: 92%

Key Population Hotspots in Nigeria for Targeted HIV Program Planning: Mapping, Validation, and Reconciliation

Lo¹,

Nwafor²,

Schwitters³

et al. 2021

JMIR Public Health Surveill

View full text Add to dashboard Cite

show abstract

“…These represent the 2 largest cities and cities with high absolute and relative population of sex workers. 49 This study was conducted from December 2015 to October 2016 as a baseline assessment to inform service provision models for the Continuum of prevention, care, and treatment of HIV/AIDS with Most at-risk Populations (CHAMP) program, implemented by an alliance of community-based organizations (CBOs) and led by the nongovernmental organization CARE.…”

Section: Study Overview and Populationmentioning

confidence: 99%

Unmet Need for Family Planning and Experience of Unintended Pregnancy Among Female Sex Workers in Urban Cameroon: Results From a National Cross-Sectional Study

Bowring

Schwartz

Lyons

et al. 2020

Glob Health Sci Pract

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Female sex workers (FSWs) in Cameroon have unmet need for effective contraception, and experience of unintended pregnancy and pregnancy termination is common. Reducing barriers to accessing high-quality, voluntary family planning services in FSW-focused community services is a key strategy to promote clientcentered care, promote informed choice, reduce unintended pregnancies, and improve quality of life for FSWs. Résumé en français à la fin de l'article.

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“…The three-source capture re-capture used both the capture re-capture as well as time-location-sampling (TLS) during the survey to arrive at the size estimates for the roamers. This methodological approach (3-SCRC) differ from those that were employed in Mozambique (sequential sampling, unique object, unique event), Sri Lanka (unique object multiplier and a modified Delphi method), Uganda (Bayesian nonparametric latent-class model), Papua New Guinea (unique object multiplier successive sampling-population size estimation) and Cameroon (Poisson regression model) [ 10 – 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…In recent times, a number of studies have been carried out using varied methods to estimate the size of key populations. These include multiplier method, Capturerecapture (CRC) [6][7][8][9][10][11], Respondent-driven sampling (RDS) through successive samplingpopulation size estimation (SS-PSE) using imputed visibility and three-source capture-recapture (3SCRC) [12][13][14] and Census and Enumeration [15].…”

Section: Introductionmentioning

confidence: 99%

National and subnational size estimation of female sex workers in Ghana 2020: Comparing 3-source capture-recapture with other approaches

Guure

Dery²,

Afagbedzi³

et al. 2021

PLoS ONE

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Background Key Population size estimation (PSE) is instrumental for HIV/STI preventive, treatment and care services planning, implementation and delivery. The objective was to estimate the overall population of female sex workers (FSW) in all the 16 regions of Ghana using different PSE methods. Method Mapping of venues and complete enumeration of seaters was conducted at the formative stage prior to the bio-behavioral survey (BBS). Three PSE methods were used to derive the size estimates of FSW in the 16 regions. These include: Capture-recapture (CRC), service multiplier and three-source capture recapture (3SCRC) methods. The final choice of the estimation method used to estimate the roamer population was 3SCRC. This method was chosen because of its perfect record-linkage–hierarchic combination of three names that minimizes overmatching as well as the addition of an interaction term in the model which corrects for the dependencies in CRC. Results The total population size estimate of the female sex workers in the country obtained for roamers using capture re-capture was 41,746 (95% CI: 41,488–41,932). Using the service multiplier, the total population for both the roamers and seaters was 41,153 (95% CI: 37,242–45,984). The 3-source capture re-capture yielded 55,686 roamers FSW (95% CI: 47,686–63,686). The seater population was 4,363 FSW based on census/complete enumeration. The total population size estimate of FSW (seaters and roamers) in Ghana was 60,049 when 3SCRC and census were added. This represents about 0.76% of all estimated adult females aged 15-49yrs in Ghana. Conclusion We report population size estimates (PSE) for FSW in Ghana. These estimates are the results of 3SCRC. These findings provide a valid and reliable source of information that should be referenced by government officials and policymakers to plan, implement and provide HIV/STI preventive, treatment, and care services for FSW in Ghana.

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Mapping and size estimates of female sex workers in Cameroon: Toward informed policy for design and implementation in the national HIV program

Cited by 7 publications

References 16 publications

Key Population Hotspots in Nigeria for Targeted HIV Program Planning: Mapping, Validation, and Reconciliation

Key Population Hotspots in Nigeria for Targeted HIV Program Planning: Mapping, Validation, and Reconciliation

Unmet Need for Family Planning and Experience of Unintended Pregnancy Among Female Sex Workers in Urban Cameroon: Results From a National Cross-Sectional Study

National and subnational size estimation of female sex workers in Ghana 2020: Comparing 3-source capture-recapture with other approaches

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