title: Safer conception needs for HIV prevention among female sex workers in Burkina Faso and Togo.
abstract: BACKGROUND
  Reproductive health programming for female sex workers (FSW) may include contraceptive services but rarely addresses safer pregnancy planning.
  
  
  METHODS
  Adult FSW were enrolled into a cross-sectional study across four sites in Burkina Faso and Togo using respondent-driven sampling. Sociobehavioral questionnaires and HIV counseling and testing were administered. Sample statistics and engagement in HIV treatment were described and compared using Chi-squared statistics.
  
  
  RESULTS
  1,349 reproductive-aged FSW were enrolled from January to July 2013. Overall, 267 FSW (19.8%) were currently trying to conceive. FSW trying to conceive were more likely to test positive for HIV at enrollment as compared to women not trying to become pregnant (24.5% versus 17.7%, P < 0.01); however awareness of HIV status was similar across groups. Among FSW trying to conceive, 79.0% (211/267) had previously received HIV testing, yet only 33.8% (23/68) of HIV-infected FSW reported a previous HIV diagnosis. Overall 25.0% (17/68) of HIV-infected FSW trying to conceive were on antiretroviral therapy.
  
  
  CONCLUSIONS
  FSW frequently desire children. However engagement in the HIV prevention and treatment cascade among FSW trying to conceive is poor potentiating periconception transmission risks to partners and infants. Programs to facilitate earlier HIV diagnosis for FSW and safer conception counseling are needed as components of effective combination HIV prevention services.
authors.affiliation: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, E7138, Baltimore, MD 21205, USA.
authors.forename: Sheree R
authors.initials: SR
authors.lastname: Schwartz
authors.affiliation: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, E7138, Baltimore, MD 21205, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Papworth
authors.affiliation: Programme d'Appui au Monde Associatif et Communautaire (PAMAC), 11 BP 1023 Ouagadougou, Burkina Faso.
authors.forename: Odette
authors.initials: O
authors.lastname: Ky-Zerbo
authors.affiliation: Arc en Ciel, 80295 Lomé, Togo.
authors.forename: Simplice
authors.initials: S
authors.lastname: Anato
authors.affiliation: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, E7138, Baltimore, MD 21205, USA.
authors.forename: Ashley
authors.identifier: 0000-0001-5759-7125
authors.initials: A
authors.lastname: Grosso
authors.affiliation: Institut de Recherche en Sciences de la Santé (IRSS/CNRST), 03 BP 7192 Ouagadougou, Burkina Faso.
authors.forename: Henri Gautier
authors.initials: HG
authors.lastname: Ouedraogo
authors.affiliation: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, E7138, Baltimore, MD 21205, USA.
authors.forename: Sosthenes
authors.initials: S
authors.lastname: Ketende
authors.affiliation: Conseil National de Lutte contre le SIDA du Togo (National AIDS Council), Faculté des Sciences de la Santé, Université de Lomé, 01 BP 2237 Lomé, Togo.
authors.forename: Vincent Palokinam
authors.initials: VP
authors.lastname: Pitche
authors.affiliation: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, E7138, Baltimore, MD 21205, USA.
authors.forename: Stefan
authors.identifier: 0000-0002-5482-2419
authors.initials: S
authors.lastname: Baral
mesh_terms: D000293:Adolescent; D000328:Adult; D002050:Burkina Faso / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005193:Family Planning Services; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D012309:Risk-Taking; D060386:Sex Workers / Q000706:statistics & numerical data*; D012725:Sexual Behavior; D014037:Togo / Q000453:epidemiology; D055815:Young Adult