Prevalence of HIV and other sexually transmitted infections among female sex workers in Kisumu, Western Kenya, 1997 and 2008

Hilde M Vandenhoudt, Lilian Langat, Joris Menten, Fredrick Odongo, Simon Oswago, Geoffrey Luttah, Clement Zeh, Tania Crucitti, Kayla Laserson, John Vulule, Anne Buve, Hilde M Vandenhoudt, Lilian Langat, Joris Menten, Fredrick Odongo, Simon Oswago, Geoffrey Luttah, Clement Zeh, Tania Crucitti, Kayla Laserson, John Vulule, Anne Buve

Abstract

Background: In 1997, a survey in Kisumu found a prevalence of HIV infection among female sex workers (FSW) of 75%. Only 50% reported using a condom with the last client. In 2008, we conducted another survey to collect data to inform an intervention targeting FSW in Kisumu.

Methods: In 2008 FSW were recruited by respondent-driven sampling. Women completed a questionnaire and were tested for HIV and other sexually transmitted infections (STIs). Multiple logistic regression analysis was done to explore factors associated with HIV-infection, and with condom use. Prevalence of HIV infection was compared in the two surveys from 1997 and 2008. Multivariate analysis was used to assess whether a change in HIV prevalence between the two surveys could be explained by changes in socio-demographic characteristics and/or behavioral factors.

Results: 481 FSW participated in the 2008 study. HIV prevalence was 56.5% (95% CI 52.0-61.6). Factors independently associated with HIV were age older than 29 years; being a widow; STI treatment in the past year; herpes simplex virus Type-2 infection; bacterial vaginosis; and trichomoniasis. Condom use with last client was reported by 75.0% (95% CI 70.9-78.9). Predictors of condom use with the last client were age older than 29 years; higher price paid by last client; ever having been tested for HIV. Predictors of unprotected sex were being drunk during last sex act; usually having sex during menses; and STI treatment in the past year. The odds ratio of HIV infection associated with year of survey was 0.49 (95% CI 0.33-0.75) after adjusting for socio-demographic and behavioral factors.

Conclusions: The prevalence of HIV among FSW in Kisumu was found to be lower in 2008 than in 1997, while reported condom use was higher. However, access to HIV/STI prevention and care services needs to improve to further decrease HIV transmission between FSW and their clients.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

    1. D’Costa LJ, Plummer FA, Bowmer I, Fransen L, Piot P, et al. (1985) Prostitutes are a major reservoir of sexually transmitted diseases in Nairobi, Kenya. Sex Transm Dis 2: 64–67.
    1. Kreiss JK, Koech D, Plummer FA, Holmes KK, Lightfoot M, et al. (1986) AIDS virus infection in Nairobi prostitutes. Spread of the epidemic to East Africa. N Engl J Med 314: 414–418.
    1. Ngugi EN, Plummer FA, Simonsen JN, Cameron DW, Bosire M, et al. (1988) Prevention of transmission of human immunodeficiency virus in Africa: effectiveness of condom promotion and health education among prostitutes. Lancet 2 (8616): 887–890.
    1. Piot P, Plummer FA, Rey MA, Ngugi EN, Rouzioux C, et al. (1987) Retrospective seroepidemiology of AIDS virus infection in Nairobi populations. J Infect Dis 155: 1108–1112.
    1. Plummer FA, Nagelkerke NJ, Moses S, Ndinya-Achola JO, Bwayo J, et al. (1991) The importance of core groups in the epidemiology and control of HIV-1 infection. AIDS 5 (Suppl 1)S169–S176.
    1. Simonsen JN, Plummer FA, Ngugi EN, Black C, Kreiss JK, et al. (1990) HIV infection among lower socioeconomic strata prostitutes in Nairobi. AIDS 4: 139–144.
    1. Robinson NJ, Mulder D, Auvert B, Whitworth J, Hayes R (1999) Type of partnership and heterosexual spread of HIV infection in rural Uganda: results from simulation modelling. Int J STD AIDS 10: 718–725.
    1. Kenya National AIDS Control Council (2009) Kenya Analysis of HIV prevention response and Modes of Transmission Study.
    1. Colvin M, Gorgens-Albino M, Kasedde S (2008) Analysis of HIV responses and Modes of HIV Transmission: the UNAIDS-GAMET supported Synthesis Project.
    1. Maleta K, Bowie C (2010) Selecting HIV infection prevention interventions in the mature HIV epidemic in Malawi using the mode of transmission model. BMC Health Serv Res 10: 243.
    1. Uganda National AIDS Commission (2009) Uganda HIV Modes of Transmission and Prevention Response Analysis.
    1. Leclerc PM, Garenne M (2008) Commercial sex and HIV transmission in mature epidemics: a study of five African countries. Int J STD AIDS 19: 660–664.
    1. Kenya National Bureau of Statistics (KNBS) and ICF Macro (2010) Kenya Demographic and Health Survey 2008–09. Calverton, Maryland: KNBS and ICF Macro.
    1. Morison L, Weiss HA, Buve A, Caraël M, Abega SC, et al. (2001) Commercial sex and the spread of HIV in four cities in sub-Saharan Africa. AIDS 15 (Suppl 4)S61–S69.
    1. Vuylsteke B, Vandenhoudt H, Langat L, Semde G, Menten J, et al. (2010) Capture-recapture for Estimating the Size of the Female Sex Worker Population in Three Cities in Côte d’Ivoire and in Kisumu, Western Kenya. Trop Med Int Hlth 15: 1537–1543.
    1. Heckathorn DD (1997) Respondent-driven sampling: A new approach to the study of hidden populations. Soc Probl 44: 174–199.
    1. Ministry of Health Kenya (2005) Kenya National Guidelines for Research and Development of HIV/AIDS Vaccines.
    1. Orle KA, Gates CA, Martin DH, Body BA, Weiss JB (1996) Simultaneous PCR detection of Haemophilus ducreyi, Treponema pallidum, and herpes simplex virus types 1 and 2 from genital ulcers. J Clin Microbiol 34: 49–54.
    1. Van Dyck E, Buvé A, Weiss HA, Glynn JR, Brown DWG, et al. (2004) Performance of commercially available enzyme immunoassays for detection of antibodies against herpes simplex virus type 2 in African populations. J Clin Microbiol 42: 2961–65.
    1. StataCorp (2007) Stata Statistical Software: Release 10. College Station, TX: StataCorp LP.
    1. Volz E, Wejnert C, Degani I, DD Heckatorn (2007) Respondent-Driven Sampling Analysis Tool (RDSAT) Version 5.6. Ithaca, NY: Cornell University.
    1. Lohr SL (2009) Sampling: Design and Analysis. Pacific Grove, CA: Duxbury Press.
    1. Korn EL, Graubard BI (1995) Examples of differing weighted and unweighted estimates from a sample survey. Am Stat 49: 291–295.
    1. Morris CN, Morris SR, Ferguson AG (2009) Sexual behavior of female sex workers and access to condoms in Kenya and Uganda on the Trans-Africa highway. AIDS Behav 13: 860–865.
    1. Victora CG, Huttly SR, Fuchs SC, Olinto MT (1997) The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. Int J Epidemiol 26: 224–7.
    1. Hawken MP, Melis RD, Ngombo DT, Mandaliya K, Ng’ang’a LW, et al. (2002) Part time female sex workers in a suburban community in Kenya: a vulnerable hidden population. Sex Transm Infect 78: 271–273.
    1. Lau JT, Ho SP, Yang X, Wong E, Tsui HY, et al. (2007) Prevalence of HIV and factors associated with risk behaviours among Chinese female sex workers in Hong Kong. AIDS Care 19: 721–732.
    1. Li Y, Detels R, Lin P, Fu X, Deng Z, et al. (2010) Prevalence of HIV and STIs and associated risk factors among female sex workers in Guangdong Province, China. J Acquir Immune Defic Syndr 53 (Suppl 1)S48–S53.
    1. Ramesh BM, Beattie TS, Shajy I, Washington R, Jagannathan L, et al. (2010) Changes in risk behaviours and prevalence of sexually transmitted infections following HIV preventive interventions among female sex workers in five districts in Karnataka state, south India. Sex Transm Infect 86 (Suppl 1)i17–i24.
    1. Stoebenau K, Hindin MJ, Nathanson CA, Rakotoarison PG, Razafintsalama V (2009) “… But then he became my sipa”: the implications of relationship fluidity for condom use among women sex workers in Antananarivo, Madagascar. Am J Public Health 99: 811–819.
    1. Voeten HA, Egesah OB, Varkevisser CM, Habbema JD (2007) Female sex workers and unsafe sex in urban and rural Nyanza, Kenya: regular partners may contribute more to HIV transmission than clients. Trop Med Int Hlth 12: 174–182.
    1. Wang C, Hawes SE, Gaye A, Sow PS, Ndoye I, et al. (2007) HIV prevalence, previous HIV testing, and condom use with clients and regular partners among Senegalese commercial sex workers. Sex Transm Infect 83: 534–540.
    1. Chersich MF, Luchters SM, Malonza IM, Mwarogo P, King’ola N, et al. (2007) Heavy episodic drinking among Kenyan female sex workers is associated with unsafe sex, sexual violence and sexually transmitted infections. Int J STD AIDS 18: 764–769.
    1. Chersich MF, Rees HV (2010) Causal links between binge drinking patterns, unsafe sex and HIV in South Africa: it’s time to intervene. Int J STD AIDS 21: 2–7.
    1. Hendershot CS, Stoner SA, Pantalone DW, Simoni JM (2009) Alcohol use and antiretroviral adherence: review and meta-analysis. J Acquir Immune Defic Syndr 52: 180–202.
    1. Diallo BL, Alary M, Barry A, Rashed S (2010) [HIV epidemic among female sex workers in Guinea: prevalence, associated risk factors, vulnerability and trend from 2001 to 2007]. Rev Epidemiol Sante Publique 58: 245–254.
    1. Hanenberg R, Rojanapithayakorn W (1998) Changes in prostitution and the AIDS epidemic in Thailand. AIDS Care 10: 69–79.

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