title: HIV seroprevalence and high-risk sexual behavior among female sex workers in Central Brazil.
abstract: Female sex workers (FSWs) are considered a high-risk group for human immunodeficiency virus (HIV) infection due to their social vulnerability and factors associated with their work. We estimated the prevalence of HIV, and identified viral subtypes and risk factors among FSWs. A cross-sectional study using respondent-driven sampling (RDS) method was conducted among 402 FSWs in Campo Grande city, Brazil, from 2009 to 2011. Participants were interviewed using a standardized questionnaire about sociodemograpic characteristics and risk behavior. Blood samples were collected for serological testing of HIV. Of the 402 FSWs, median age and age of initiating sex work were 25 years (Interquartile range [IQR]: 9) and 20 years (IQR: 6), respectively. The majority reported use of alcohol (88.5%), had 5-9 years (median: 9; IQR: 3) of schooling (54.5%), 68.6% had tattoos/body piercings, and 45.1% had more than seven clients per week (median: 7; IQR: 10). Only 32.9% of FSW reported using a condom with nonpaying partners in the last sexual contact. Prevalence of HIV infection was 1.0% (95% CI: 0.1-2.6%). Genotyping for HIV-1 performed on three samples detected subtypes B, C, and F1. Sex work in the Midwestern region of Brazil is characterized by reduced education, large numbers of clients per week, and inconsistent condom use, mainly with nonpaying partners. Although prevalence of HIV infection is currently low, elevated levels of high-risk sexual behavior confirm a need to implement prevention measures. Specific interventions targeting FSWs must emphasize the risk associated with both clients and nonpaying partners while providing knowledge about HIV prevention.
authors.affiliation: a Department of Biochemistry and Pharmacy , Federal University of Mato Grosso do Sul , Campo Grande , Mato Grosso do Sul , Brazil.
authors.forename: Fernanda R P
authors.initials: FR
authors.lastname: Fernandes
authors.forename: Gina J
authors.initials: GJ
authors.lastname: Mousquer
authors.forename: Lisie S
authors.initials: LS
authors.lastname: Castro
authors.forename: Marco A
authors.initials: MA
authors.lastname: Puga
authors.forename: Tayana S O
authors.initials: TS
authors.lastname: Tanaka
authors.forename: Grazielli R
authors.initials: GR
authors.lastname: Rezende
authors.forename: Clarice S
authors.initials: CS
authors.lastname: Pinto
authors.forename: Larissa M
authors.initials: LM
authors.lastname: Bandeira
authors.forename: Regina M B
authors.initials: RM
authors.lastname: Martins
authors.forename: Roberta B L
authors.initials: RB
authors.lastname: Francisco
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Teles
authors.forename: Ana R C
authors.initials: AR
authors.lastname: Motta-Castro
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D046289:Body Modification, Non-Therapeutic / Q000706:statistics & numerical data; D001938:Brazil / Q000453:epidemiology; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D015528:HIV Seroprevalence; D006801:Humans; D012307:Risk Factors; D012309:Risk-Taking; D060386:Sex Workers; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D047568:Unsafe Sex
keywords: Central Brazil; HIV; female sex workers; sexual behavior