HIV prevalence and incidence amongst sex workers remains high in Zimbabwe

MOPE345 – Poster Exhibition

HIV prevalence and incidence amongst sex workers remains high in Zimbabwe

F. Cowan1,2, S. Mtetwa2, E. Fearon3, T. Ndikudze4, R. Wong-Gruenwald4, S. Chidiya5, J. Dirawu2, C. Benedikt5, J. Busza3, J. Hargreaves3

1University College London, Research Department of Infection & Population Health, Harare, Zimbabwe, 2University of Zimbabwe, ZAPP-UZ, Community Medicine, Harare, Zimbabwe, 3London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom, 4Gesellschaft für Internationale Zusammenarbeit (GIZ), Harare, Harare, Zimbabwe, 5UNFPA Zimbabwe, Harare, Zimbabwe

 

Background: A bio-behavioural survey was conducted among sex workers (SWs) in Mutare, Hwange, Victoria Falls in Zimbabwe using respondent driven sampling (RDS) to determine their demographic and behavioral characteristics plus HIV prevalence.

Methods: Rapid ethnographic mapping was conducted at each site. Ten seeds were selected in Mutare and six each in Hwange and Victoria Falls. Each participant completed an interviewer-administered questionnaire and provided blood for HIV testing. Each participant was asked to refer two peers. Data were weighted to take account of RDS and analyzed using Stata 12.

Results: 370 women were recruited from Mutare; 237 from Hwange and 229 from Victoria Falls (total N= 836). Women ranged from 18-61 years old. The primary site for solicitation was bars/nightclubs. SWs in Victoria Falls were younger and more recently started in sex work than SWs from Mutare and Hwange. Knowledge of modes of HIV transmission was high (>90%). 40% of women reported having >5 clients/week; only 70-85% reported always using condoms with clients in the past month. 75% of women said they had at least one permanent partner and reported condom use with these partners was around 55%. 78% of SWs in Mutare, 71% in Hwange and 82% in Victoria Falls reported ever testing for HIV. The proportion testing in the previous 6 months was 42%, 38% and 21% respectively. Weighted HIV prevalence was 51% (95%CI:43-58%) in Mutare, 51% in Hwange (95%CI:41-59%) and 70% in Victoria Falls (95%CI:62-77%) and increased marked with age

Conclusions: HIV prevalence is high (4 times that in antenatal clinic attenders) and is similar to prevalence amongst SWs in 2001, despite substantial reductions over this period among women more generally. Incidence around time of initiation is high. Prioritizing young SWs for prevention of acquisition of HIV, and treatment for prevention for more established (likely HIV positive) SWs is clearly important.

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Posted on July 23, 2012, in Uncategorized. Bookmark the permalink. Comments Off on HIV prevalence and incidence amongst sex workers remains high in Zimbabwe.

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