Abstract
Background:
Female sex workers (FSWs) account for about 20% of new HIV infections in
Nigeria. We estimated the change in HIV prevalence and sexual risk
behaviors between 2 consecutive rounds of integrated biological and
behavioral surveillance surveys (IBBSSs) and determined correlates of
HIV transmission among FSWs.
Methods:
In 2007 and 2010, HIV prevalence and risk behavior data on brothel-based
(BB) and non-brothel-based (NBB) FSWs from the integrated biological
and behavioral surveillance survey were evaluated in 6 Nigerian states.
Logistic regression was used to identify correlates of HIV infection.
Results:
A total of 2897 and 2963 FSWs were surveyed in 2007 and 2010,
respectively. Overall HIV prevalence decreased in 2010 compared to 2007
(20% vs. 33%; P < 0.001), with similar magnitude of declines among
BB-FSW (23% vs. 37%; P < 0.0001) and NBB-FSW (16% vs. 28%; P <
0.0001). Consistent condom use with boyfriends in the last 12 months was
lower in 2010 compared to 2007 overall (23% vs. 25%; P = 0.02) and
among BB-FSWs (17% vs. 23%; P < 0.01] while NBB-FSWs showed a
marginal increase (30% vs. 27%; P = 0.08). FSWs residing in the Federal
Capital Territory [adjusted odds ratio (AOR): 1.74 (1.34 - 2.27)] and
Kano state [AOR: 2.07 (1.59 - 2.70)] were more likely to be HIV-positive
while FSWs recruited in 2010 [AOR: 0.81 (0.77-0.85)] and those who had
completed secondary education [AOR: 0.70 (0.60-0.80)] were less likely
to be HIV-positive.
Conclusions:
Results suggest significant progress in reducing the burden of HIV among
FSWs in Nigeria, although low condom use with boyfriends continued to
be a potential bridge between FSWs and the general population.
Venue-based prevention programs are needed to improve safer sex
practices among BB-FSWs.
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