title: Prevalence of HIV, sexually transmitted infections, and risk behaviours among female sex workers in Nairobi, Kenya: results of a respondent driven sampling study.
abstract: We conducted a respondent driven sampling survey to estimate HIV prevalence and risk behavior among female sex workers (FSWs) in Nairobi, Kenya. Women aged 18 years and older who reported selling sex to a man at least once in the past 3 months were eligible to participate. Consenting FSWs completed a behavioral questionnaire and were tested for HIV and sexually transmitted infections (STIs). Adjusted population-based prevalence and 95 % confidence intervals (CI) were estimated using RDS analysis tool. Factors significantly associated with HIV infection were assessed using log-binomial regression analysis. A total of 596 eligible participants were included in the analysis. Overall HIV prevalence was 29.5 % (95 % CI 24.7-34.9). Median age was 30 years (IQR 25-38 years); median duration of sex work was 12 years (IQR 8-17 years). The most frequent client-seeking venues were bars (76.6 %) and roadsides (29.3 %). The median number of clients per week was seven (IQR 4-18 clients). HIV testing was high with 86.6 % reported ever been tested for HIV and, of these, 63.1 % testing within the past 12 months. Of all women, 59.7 % perceived themselves at 'great risk' for HIV infection. Of HIV-positive women, 51.0 % were aware of their infection. In multivariable analysis, increasing age, inconsistent condom use with paying clients, and use of a male condom as a method of contraception were independently associated with unrecognized HIV infection. Prevalence among STIs was low, ranging from 0.9 % for syphilis, 1.1 % for gonorrhea, and 3.1 % for Chlamydia. The data suggest high prevalence of HIV among FSWs in Nairobi. Targeted and routine HIV and STI combination prevention strategies need to be scaled up or established to meet the needs of this population.
authors.affiliation: National AIDS and Sexually Transmitted Infection Control Programme, Ministry of Health, P.O. Box 19361-00202, Nairobi, Kenya, helgar@nascop.or.ke.
authors.forename: Helgar
authors.initials: H
authors.lastname: Musyoki
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Kellogg
authors.forename: Scott
authors.initials: S
authors.lastname: Geibel
authors.forename: Nicholas
authors.initials: N
authors.lastname: Muraguri
authors.forename: Jerry
authors.initials: J
authors.lastname: Okal
authors.forename: Waimar
authors.initials: W
authors.lastname: Tun
authors.forename: H
authors.initials: H
authors.lastname: Fisher Raymond
authors.forename: Sufia
authors.initials: S
authors.lastname: Dadabhai
authors.forename: Meredith
authors.initials: M
authors.lastname: Sheehy
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Kim
mesh_terms: D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012309:Risk-Taking; D012494:Sampling Studies; D011477:Sex Work / Q000706:statistics & numerical data*; D060386:Sex Workers / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult