Yves Lafort 1, Ross Greener 2, Anuradha Roy 3, Letitia Greener 2, Wilkister Ombidi 4, Faustino Lessitala 5, Hassan Haghparast-Bidgoli 6, Mags Beksinska 2, Peter Gichangi 7 4 8, Sushena Reza-Paul 9, Jenni A Smit 2 10, Matthew Chersich 7 11, Wim Delva 7 12 13
Affiliations
- 1International Centre for Reproductive Health, Ghent University, Gent, Belgium. yves.lafort@ugent.be.
- 2MatCH Research Unit, University of the Witwatersrand, Durban, South Africa.
- 3Ashodaya Samithi, Mysore, India.
- 4International Centre for Reproductive Health-Kenya, Mombasa, Kenya.
- 5International Centre for Reproductive Health-Mozambique, Maputo, Mozambique.
- 6Institute for Global Health, University College London, London, UK.
- 7International Centre for Reproductive Health, Ghent University, Gent, Belgium.
- 8University of Nairobi, Nairobi, Kenya.
- 9University of Manitoba, Winnipeg, MB, Canada.
- 10Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
- 11Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
- 12The South African DST/NRF Centre of Excellence in Epidemiological Modelling and Analysis, University of Stellenbosch, Stellenbosch, South Africa.
- 13Center for Statistics, Hasselt University, Diepenbeek, Belgium.
PMID: 27479236
DOI: 10.1111/tmi.12761
Abstract
Objective: To identify gaps in the use of HIV prevention and care services and commodities for female sex workers, we conducted a baseline cross-sectional survey in four cities, in the context of an implementation research project aiming to improve use of sexual and reproductive health services.
Methods: Using respondent-driven sampling, 400 sex workers were recruited in Durban, 308 in Tete, 400 in Mombasa and 458 in Mysore and interviewed face-to-face. RDS-adjusted proportions were estimated by nonparametric bootstrapping and compared across cities using post hoc pairwise comparison.
Results: Condom use with last client ranged from 88.3% to 96.8%, ever female condom use from 1.6% to 37.9%, HIV testing within the past 6 months from 40.5% to 70.9%, receiving HIV treatment and care from 35.5% to 92.7%, care seeking for last STI from 74.4% to 87.6% and having had at least 10 contacts with a peer educator in the past year from 5.7% to 98.1%. Many of the differences between cities remained statistically significant (P < 0.05) after adjusting for differences in FSWs’ socio-demographic characteristics.
Conclusion: The use of HIV prevention and care by FSWs is often insufficient and differed greatly between cities. Differences could not be explained by variations in socio-demographic sex worker characteristics. Models to improve use of condoms and HIV prevention and care services should be tailored to the specific context of each site. Programs at each site must focus on improving availability and uptake of those services that are currently least used.
© 2016 John Wiley & Sons Ltd.
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