High prevalence of HIV infection among female sex workers in Nairobi, Kenya: results of a respondent-driven sampling study, 2010-2011

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High prevalence of HIV infection among female sex workers in Nairobi, Kenya: results of a respondent-driven sampling study, 2010-2011

H. Musyoki1, A. Kim2, S. Geibel3, N. Muraguri1, J. Okal3, S. Dadabhai4, M. Muthui2, M. Sheehy5, D. Broz6, T. Kellogg4

1National AIDS and STI Control Programme (NASCOP), Nairobi, Kenya, 2Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya, 3Popoulation Council, Nairobi, Kenya, 4University of California at San Francisco, Nairobi, Kenya, 5Popoulation Council, New York, United States, 6Centers for Disease Control and Prevention (CDC), Atlanta, United States

Background: In Kenya, national surveillance activities have adopted respondent-driven sampling (RDS), a probability-based sampling method, to provide reliable estimates among populations at highest risk for HIV. To date, no population-based data on HIV and sexually transmitted infections (STIs) exist among female sex workers (FSWs) in Kenya.

 

Methods: From October 2010 to January 2011, we used RDS to estimate prevalence of HIV, STIs, and behaviors among FSWs in Nairobi, Kenya. Women ≥18 years who sold sex to men in the past 3-months were screened, administered a behavioral questionnaire, and tested for HIV, gonorrhea, chlamydia, and syphilis. Adjusted population-based prevalence and 95% confidence intervals (CI) were estimated. Independent risk factors for HIV infection were assessed using logistic regression.

 

Results: Among 596 consenting FSWs, HIV prevalence was 29.3% (CI 24.6-34.9). Median age was 30 years (range 18-62), median duration of sex work was 12 years (range 4-45), and median number of clients/week was seven (range 0-31). Ninety percent reported ‘ever’ being tested for HIV; 54% tested in the past 12-months. Three-quarters of participants perceived themselves at ‘great risk’ or reported being HIV-positive. Of 183 HIV seropositive women, 54% were aware of their infection. HIV was independently associated with increasing duration of sex work (adjusted odds ratio [AOR]=7.0; CI 2.1-24.1), never testing for HIV (AOR=8.1; CI 1.8-37.8), and female condom use (AOR=6.1; CI 1.5-24.0). Among HIV-positive women, female condom use was higher for those aware of their infection (15.4%; CI 6.1-26.3) compared to women unaware (3.5%; CI 1.0-9.1). Oral contraception use was negatively associated with HIV (AOR=0.1; CI 0.01-0.7). Prevalence of syphilis was 0.9% (CI 0.2-2.0), gonorrhea was 3.1% (CI 1.5-5.3), and chlamydia was 1.1% (CI 0.4-2.1).

 

Conclusions: We found high HIV prevalence among FSWs in Nairobi, but low STI prevalence. Targeted prevention strategies should continue to scale-up with on-going surveillance to measure impact of these interventions.

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Posted on July 23, 2012, in Uncategorized. Bookmark the permalink. Comments Off on High prevalence of HIV infection among female sex workers in Nairobi, Kenya: results of a respondent-driven sampling study, 2010-2011.

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