title: Estimating HIV prevalence and HIV-related risk behaviors among heterosexual women who have multiple sex partners using respondent-driven sampling in a high-risk community in South Africa.
abstract: BACKGROUND
  Repeated surveillance surveys are important for monitoring trends in HIV and risk behaviors over time. In countries most adversely affected by HIV and AIDS, community-level HIV biological and behavioral surveillance surveys are needed among subpopulations who engage in high-risk sexual behaviors.
  
  
  OBJECTIVE
  To describe the effectiveness of respondent-driven sampling (RDS) to recruit heterosexual women who have multiple concurrent sexual partnerships, to report HIV prevalence and describe key characteristics among them, and to assess whether RDS-accessed women not usually recruited during routine sentinel surveillance surveys.
  
  
  METHODS
  We conducted a HIV biological and behavioral surveillance surveys using RDS among women. Participants completed an audio-computer-assisted survey interview, voluntarily provided dried blood spots for HIV testing, and were offered rapid HIV testing.
  
  
  RESULTS
  The analytical sample comprised 845 women whose mean age was 23.9 years. About 6.4% were married, 49.6% lived in informal dwellings, and 31.8% reported not to have enough money for food. HIV prevalence was 28.8% (95% confidence intervals: 24.3 to 33.4). Being between 20 and 29 years was significantly related to HIV infection. Women who had never attended a public health facility (10.1%) compared with those who had were more likely to be 16-19 years (P = 0.008), reported sexual debut at 10-14 years (P = 0.044), were more likely to have experienced a symptom of a sexually transmitted infection (P = 0.031), and to have taken illegal drugs (P = 0.007).
  
  
  CONCLUSIONS
  RDS effectively recruited women who reported 2 or more male sexual partners in the past 3 months. HIV prevalence and HIV-related risk behaviors were high among women who have multiple concurrent partners.
authors.affiliation: *South African Medical Research Council, Tygerberg, South Africa †University of Cape Town.
authors.forename: Loraine
authors.initials: L
authors.lastname: Townsend
authors.forename: Yanga
authors.initials: Y
authors.lastname: Zembe
authors.forename: Catherine
authors.initials: C
authors.lastname: Mathews
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Mason-Jones
mesh_terms: D005260:Female; D015528:HIV Seroprevalence; D006801:Humans; D012309:Risk-Taking; D012747:Sexual Partners; D013019:South Africa