title: An appraisal of female sex work in Nigeria--implications for designing and scaling up HIV prevention programmes.
abstract: BACKGROUND
  The HIV epidemic in Nigeria is complex with diverse factors driving the epidemic. Accordingly, Nigeria's National Agency for the Control of AIDS is coordinating a large-scale initiative to conduct HIV epidemic appraisals across all states. These appraisals will help to better characterize the drivers of the epidemic and ensure that the HIV prevention programmes match the local epidemic context, with resources allocated to interventions that have the greatest impact locally. Currently, the mapping and size estimation of Female Sex Workers (FSWs)--a major component of the appraisal has been completed in seven states. These states are using the data generated to plan, prioritize and scale-up sub-national HIV prevention programmes.
  
  
  METHODS
  It involved a two-level process of identifying and validating locations where FSWs solicit and/or meet clients ("hotspots"). In the first level, secondary key informants were interviewed to collect information about the geographic location and description of the hotspots. For the second level, FSWs were interviewed at each hotspot and information on population size estimates, typologies and operational dynamics of the FSWs were collected.
  
  
  RESULTS
  Across the seven states, a total of 17,266 secondary key informants and 5,732 FSWs were interviewed. 10,233 hotspots were identified with an estimated 126,489 FSWs ranging from 5,920 in Anambra to 46,691 in Lagos. The most common hotspots were bars/nightclubs (30%), hotels/lodges (29.6%), streets (16.6%), and brothels (14.6%). Furthermore, the population density of FSWs (per thousand adult men) across the states ranged from 2 in Anambra to 17 in the Federal Capital Territory.
  
  
  CONCLUSIONS
  FSW populations in Nigeria are large and diverse, with substantial differences between and within states. Improved understanding of the location, population size, density, organizational typologies and clients of sex work has informed and is central to Nigeria's planning process for scaling up focused HIV prevention programmes.
authors.affiliation: National Agency for the Control of AIDS, Abuja, Nigeria.
authors.forename: Akudo
authors.initials: A
authors.lastname: Ikpeazu
authors.affiliation: Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
authors.forename: Amaka
authors.initials: A
authors.lastname: Momah-Haruna
authors.affiliation: Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
authors.forename: Baba
authors.initials: B
authors.lastname: Madu Mari
authors.affiliation: Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
authors.forename: Laura H
authors.initials: LH
authors.lastname: Thompson
authors.affiliation: National Agency for the Control of AIDS, Abuja, Nigeria.
authors.forename: Kayode
authors.initials: K
authors.lastname: Ogungbemi
authors.affiliation: National Agency for the Control of AIDS, Abuja, Nigeria.
authors.forename: Uduak
authors.initials: U
authors.lastname: Daniel
authors.affiliation: National Agency for the Control of AIDS, Abuja, Nigeria.
authors.forename: Hafsatu
authors.initials: H
authors.lastname: Aboki
authors.affiliation: Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
authors.forename: Shajy
authors.initials: S
authors.lastname: Isac
authors.affiliation: World Bank, Washington, DC, United States of America.
authors.forename: Marelize
authors.initials: M
authors.lastname: Gorgens
authors.affiliation: World Bank, Washington, DC, United States of America.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Mziray
authors.affiliation: World Bank, Washington, DC, United States of America.
authors.forename: Ndella
authors.initials: N
authors.lastname: Njie
authors.affiliation: World Bank, Washington, DC, United States of America.
authors.forename: Francisca Ayodeji
authors.initials: FA
authors.lastname: Akala
authors.affiliation: Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
authors.forename: Faran
authors.initials: F
authors.lastname: Emmanuel
authors.affiliation: Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
authors.forename: Willis Omondi
authors.initials: WO
authors.lastname: Odek
authors.affiliation: Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
authors.forename: James F
authors.initials: JF
authors.lastname: Blanchard
mesh_terms: D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D009313:National Health Programs; D009549:Nigeria; D060386:Sex Workers