Readiness of female sex workers for HIV testing and its associated factors in Shire Endaselassie town, Tigray, Ethiopia: a cross-sectional study (original) (raw)
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HIV/AIDS - Research and Palliative Care
Background: Human immunodeficiency virus self-testing (HIVST) is universally accepted as an HIV testing option to achieve the United Nations Agency for International Development first 95 goal by 2030. HIV testing coverage through voluntary counseling and testing and provider initiated testing and counseling is low among female sex workers (FSWs). However, there is no evidence on the level of HIVST among FSWs in the study area. Objective: To assess the uptake of HIVST and associated factors among FSWs at non-governmental facilities in Debre Markos and Bahir Dar towns, Northwest Ethiopia, 2022. Methods: An institution-based cross-sectional study design was employed. A total of 423 study participants were selected by systematic random sampling technique. The data were collected using a structured and pre-tested questionnaire; entered into EpiData version 3.1 and exported to SPSS version 25 for analysis. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was estimated to assess the strength of association between independent variables and dependent variable. Bivariable logistic regression was done for each variable and those with a P-value of < 0.25% were selected for multivariable analysis. Finally, P-value < 0.05% was declared statistically significant. Results: The magnitude of HIVST uptake among FSWs was 59.3%. Time since engagement of sex work > 5 years [AOR 2.16 (95% CI: 1.158-4.013)], age of first sexual debut >19 years [AOR 3.23 (95% CI: 2.045-5.093)], previous urban residence [AOR 3.99 (95% CI: 2.58-6.18)], good knowledge towards HIVST [AOR 1.78 (95% CI: 1.066-2.964)], education status being college and above [AOR 5.6 (95% CI: 3.12-9.30)] were significantly associated factors. Conclusion: HIVST uptake among FSWs was 59.3% which is lower than expected at national level. Educational status, age at first sexual debut, knowledge towards HIVST, and time since engagement in sex work were significantly associated with HIVST uptake.
Factors associated with HIV testing among female sex workers in Botswana
Journal of AIDS and HIV Research, 2017
Botswana continues to have a high level of HIV prevalence, with about 17% of the population living with HIV AIDS (BAIS IV, 2013). Female sex workers are classified among the most at risk population group in the country. However, sub-national disaggregated data on new infections are not available. Hence, there is a need to focus great attention on other proxies of infection. The present study examines predictors of HIV testing among female sex workers (FSWs) in Botswana. The FSWs were recruited into the study using the time-location cluster sampling method (TLS) to collect data on prevalence and incidence of HIV and other STIs and their risk factors for HIV. The logistic regression analysis was performed to estimate crude odds ratios and identify the factors associated with having an HIV test among the FSWs. HIV prevalence among sex workers in Botswana was found to be 3 times higher than in the general population. Analysis of the results shows that the sex workers most likely to seek HIV testing were young women with no children. The odds of testing for HIV were almost 4 times more for FSWs who had first sex older as compared to the odds of testing for those who are 17 to 19 years old. Lack of or inconsistent condom use and currently having symptoms of STIs such as lower abdominal pain and genital ulcerations were also factors associated with HIV testing. Results further show that FSW hold little discrimination and stigma related attitudes towards PLWA. FSWs have little participation in the HIV prevention, treatment and care efforts currently accessed by the general population. It is recommended is that this framework should also be extended to FSW's and their clients in order to curb HIV and STIs.
HIV/AIDS (Auckland, N.Z.), 2020
Background In developing countries, youth women are most at risk of HIV infection. Center for Disease Control recommends that people who participate in high-risk behaviors get tested for HIV at least annually. In 2016, the Ethiopian Ministry of Health set goals to identify 90% of the people living with HIV by 2030. But undiagnosed HIV infections are still high in the country. To alleviate the problem, it is vital to identify the factors that hinder HIV testing practice. Therefore, this study aimed to identify the facilitators and barriers of HIV testing practice among Ethiopian youth women. Methods The analysis was done on 6401 women aged 15–24 years using data from the 2016 Ethiopia Demographic Health Survey (EDHS). The main outcome variable was self-reported HIV testing practice. Multivariable logistic regression was used to identify the facilitators and barriers of HIV testing practice. Results In this study, 37.7% [95% CI: (33.6, 39.1)] of youth women were tested for HIV in thei...
2019
Background HIV testing is the critical first step in identifying and linking HIV infected people to the treatment cascade and it also provides an important opportunity to reinforce HIV prevention among the negatives. The aim of this study was examine factors associated with HIV testing among youth women. Methods A community-based cross-sectional study design was used and a nationally representative secondary data analysis was done on the 2016 Ethiopian Demographic and Health Survey(EDHS). A total of 6401 youth women were eligible in the study. The data were analyzed by SPSS version 20. Frequencies and weighted percentage of the variables were calculated. Chi-square tests and logistic regression models were used to assess predictors of HIV testing. Multivariate logistic regression analysis was conducted to control confounders and to identify the independent contribution of each variable to the outcome variable. Result A total of 6401 youth women aged 15 to 24 years of age were includ...
Texila International Journal of Public Health, 2023
This study investigated the awareness, willingness, and practice of HIV Pre-Exposure Prophylaxis (PrEP) among female sex workers (FSWs) in Uyo, Akwa Ibom State, Nigeria. Conducted between June and August 2020, the cross-sectional research engaged 344 HIV-negative FSWs attending services at Uyo's One-Stop Shop for key populations services. Through a semi-structured questionnaire, data were collected on awareness, willingness, and practice of PrEP, and subsequently analyzed using statistical methods. The study's participants had a mean age of 29.06±5.20 years, with 68.6% falling between 25-34 years old. Notably, 76.5% were adequately aware of PrEP, while 8.1% expressed willingness to use it, and 42.4% had practiced PrEP. Factors like age, marital status, and years engaged in sex work were found to significantly influence awareness of PrEP. Participants aged 25-34 years, those previously married, and those with fewer years in sex work exhibited greater PrEP awareness. The frequency of first-time and boyfriend clients per week impacted willingness and practice of PrEP, with the former positively influencing willingness and the latter negatively affecting practice. Engaging in unprotected sex was also found to negatively correlate with PrEP practice. These findings highlight that while awareness of PrEP is relatively high among FSWs, willingness to use and actual practice of PrEP remain low. The study underscores the importance of tailored health education programs targeting FSWs, to enhance awareness and encourage adoption of effective HIV preventive measures. By addressing factors like age, marital status, and specific aspects of sex work, interventions could be designed to increase PrEP utilization, thereby contributing to the reduction of HIV transmission in this population.
HIV & AIDS Review
Introduction: Even though HIV testing and care is highly targeted in different strategies in Ethiopia, most sexually active young females do not know their HIV status. Moreover, prior trend analysis has not been conducted among sexually active young females in Ethiopia. Therefore, this study aimed to assess the trend and determinants of HIV testing change among sexually active young females in Ethiopia. Material and methods: The current study utilized three consecutive Ethiopia Demographic and Health Survey (EDHS) datasets. A total of 1,201.9, 3,094, and 2,864.7 sexually active female youths were included in 2005, 2011, and 2016 EDHS surveys, respectively. Data were analyzed using Stata version 14.0. Logit-based decomposition analysis was performed to identify contributing factors for HIV testing change, and statistical significance was determined with p-value. Results: The trend of HIV testing increased from 7% in 2005 to 52.5% in 2016 EDHS. The analysis revealed that 19% of the overall change in HIV testing was due to the change in female youths composition. Changes in the composition of young females according to region, age, economic status, age of sexual initiation, and comprehensive HIV/ AIDS knowledge were the major sources of the change. Greater than 80% of the increase in HIV testing was due to differences in coefficient. The change in behaviors of married youths and early starting of sex life were the contributing factors to change of HIV testing over the last decade. Conclusions: Change of HIV testing among sexually active female youths increased in the last 10 years in Ethiopia. However, in order to achieve the HIV-related targets in the country, programmatic interventions targeting uneducated women is needed.
International Journal of Scientific & Engineering Research, 2019
Background: The Human Immunodeficiency Virus epidemic continues to be a major public health problem worldwide. It has become one of the world's serious health and development challenges. In sub-Sahara Africa women accounted for 56% of new HIV infections among adults in 2016. HIV testing is the first step clients take towards taking responsibility for the protection of themselves and others. By taking the voluntary step, they accept their vulnerability to HIV infection. In Somaliland the prevalence of HIV test uptake among women of reproductive age was 2.7% in 2011.Where 39,543 women attending ANC services in facilities offering PMTCT services in Somaliland, only 9,101 (23%) were tested for HIV and 5,869(0.06%) of them were HIV positive. In Somaliland the prevalence of HIV test uptake among women of reproductive age was 2.7% in 2011. Method: institutional based unmatched case control study was conducted from February 5 to March, 26, 2017. 88 Cases were women during reproductive age who were tested for HIV. 176 Controls were women during reproductive age and never tested for HIV. Descriptive and frequency statistics was done. BivariateandmultivariateanalysiswasalsoperformedusinglogisticregressiononSPSSversion21.softwarein order to determine factors associated with HIV test. Results: HIV test uptake was associated with; having less than three number of children (AOR=4.67, 95% CI=2.12, 10.29), knew on available of antiretroviral therapy (AOR=5.6, 95%CI=1.19, 26.28), perception about test confidentiality (AOR=0.09, 95%CI=0.02, 0.51), and fearing of stigma (AOR=0.05, 95%CI=0.005, 0.24) after the effect of other significant variables were controlled. Conclusion and recommendation: This study has identified; Source of information about HIV /AIDS, number of children, knowing availability of antiretroviral therapy, perceived test confidentiality an d stigma as determinants of HI V test uptake. Health care providers should motivate client to be tested for HIV by giving them adequate information about HIV/AIDs. Stigma is deeper rooted problem in community so that Intensive campaign and efforts against stigma should be taken in the community level continuously in order to root out stigma barrier.
BMC Public Health
Background: HIV testing is a gateway to HIV care and treatment for people diagnosed with HIV and can link those with negative results to HIV preventive services. Despite the importance of HIV testing services (HTS) in HIV control, uptake of HTS among female sex workers (FSWs) across sub-Saharan Africa (SSA) remains sub-optimal. Concerns about stigma associated with sex work and fear of loss of livelihood if HIV status becomes known, are some of the restrictions for FSWs to utilize HTS offered through health care facilities. Introduction of HIV self-testing (HIVST) may mitigate some of the barriers for the uptake of HTS. This study explored the acceptability of FSWs towards the introduction of HIVST in Tanzania. Methods: We conducted an exploratory study employing in-depth interviews (IDI) and participatory group discussions (PGD) with FSWs in selected regions of Tanzania. Study participants were recruited through snowball sampling. Data were thematically analysed by two analysts using NVivo software. The analysis was informed by the social-ecological model and focused on factors associated with the acceptability of HIVST. Results: We conducted 21 PGD sessions involving 227 FSWs. Twenty three IDIs were conducted to complement data collected through PGD. Our study has demonstrated that FSWs are enthusiastic toward HIVST. Convenience (time and cost saved), and belief that HIVST will increase privacy and confidentiality motivated participants' support for the self-testing approach. Participants did express concerns about their ability to interpret and trust the results of the test. Participants also expressed concern that HIVST could cause personal harm, including severe distress and self-harm for individuals with a reactive test. Very likely, concern about adverse effects of HIVST was linked to the study participants' lay perception that HIVST would be provided only through unassisted modality. Conclusions: FSWs demonstrated high enthusiasm to use the HIVST once it becomes available. Expectations for increased confidentiality, autonomy, and reduced opportunity costs were among the leading factors that attracted FSWs to HIVST. The major obstacles to the acceptability of HIVST included fear of HIV reactive test and not trusting self-diagnoses. Our findings underscore the importance of providing adequate access to counselling and referral services in conjunction with HIVST.
BMJ Open, 2020
Objective : To describe sexual and reproductive health (SRH) needs of female sex workers (FSWs) to inform the future implementation of pre-exposure prophylaxis (PrEP) for HIV prevention in this population. Design and setting : The ANRS 12361 PrEP-CI cross-sectional and mixed-methods study was designed and implemented with two community-based organisations in Côte d’Ivoire. Participants : A convenience sample of 1000 FSWs aged ≥18, not known as HIV-positive, completed a standardised questionnaire assessing sociodemographic characteristics, sexual practices, use of community health services and a priori acceptability of PrEP. Twenty-two indepth interviews and eight focus group discussions were also conducted to document FSWs’ risky practices and sexual behaviours, experiences with violence and discrimination, attitudes regarding HIV and sexually transmitted infections (STIs), and barriers to SRH services. Results : Although 87% described consistent condom use with clients, more than 22% declared accepting condomless sexual intercourse for a large sum of money. Furthermore, condom use with their steady partner and knowledge of their partner’s HIV status were low despite their acknowledged concurrent sexual partnerships. While inconsistent condom use exposed FSWs to STIs and undesired pregnancies, the prevalence of contraceptive strategies other than condoms was low (39%) due to fear of contraception causing sterility. FSWs faced obstacles to accessing SRH care and preferred advice from their peers or self-medication. Conclusions : Despite adoption of preventive behaviour in most cases, FSWs are still highly exposed to HIV. Furthermore, FSWs seem to face several barriers to accessing SRH. Implementing PrEP among FSWs in West Africa, such as in Côte d’Ivoire, constitutes an opportunity to consider the regular follow-up of HIV-negative FSWs. PrEP initiation should not condition access to SRH services; conversely, SRH services could be a way to attract FSWs into HIV prevention. Our results highlight the importance of developing a people-focused approach that integrates all SRH needs when transitioning from PrEP efficacy trials to implementation.