Female sex workers in three cities in Russia: HIV prevalence, risk factors and experience with targeted HIV prevention.
Within Eastern Europe/Central Asia's expanding HIV epidemic, relatively little is known about female sex workers (FSWs). Using mixed methods, we report on sex work context, HIV prevalence and contextual risk factors, and exposure to FSW-targeted prevention services among FSWs in Kazan, Krasnoyarsk, and Tomsk, Russia. Following a qualitative phase, FSWs (n = 754) were recruited via respondent-driven sampling for a cross-sectional survey with HIV screening in 2011. HIV was prevalent (3.9 %). In adjusted analyses, significant risk factors included injection drug use (IDU; AOR 5.85, 95 % CI 2.47, 14.43), client-perpetrated physical violence (AOR 2.52, 95 % CI 1.41, 4.51), and client-perpetrated sexual violence (vaginal AOR 3.77, 95 % CI 1.73, 8.22; anal AOR 4.80, 95 % CI 1.89, 12.19). FSW-targeted programming (reported by 75 %) was described as highly valuable, providing free, anonymous, and non-stigmatizing care. Findings confirm FSWs as a core HIV risk population in Russia, and demonstrate the need to support FSW-oriented HIV services. Such efforts should address violence against FSWs.
Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., E4142, Baltimore, MD, 21205, USA, mdecker@jhsph.edu.
Michele R
MR
Decker
Andrea L
AL
Wirtz
Vladimir
V
Moguilnyi
Alena
A
Peryshkina
Maria
M
Ostrovskaya
Marina
M
Nikita
Julia
J
Kuznetzova
Chris
C
Beyrer
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control*; D006306:Health Surveys; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D036301:Qualitative Research; D012307:Risk Factors; D012426:Russia / Q000453:epidemiology; D012742:Sex Offenses / Q000706:statistics & numerical data*; D011477:Sex Work / Q000706:statistics & numerical data*; D060386:Sex Workers; D014505:Urban Population