Sexual risk behaviors, HIV, and syphilis among female sex workers in Nepal.
OBJECTIVE
Female sex workers (FSWs) are a key-affected population susceptible to acquiring HIV and sexually transmitted infections (STIs), as well as transmitting the virus to others. The aim of the study was to assess HIV and syphilis prevalence among FSWs in Nepal and to examine factors associated with it.


METHODS
The study was based on Integrated Biological and Behavioral Surveillance (IBBS) surveys among FSWs in Nepal from 2004 to 2015. Statistical analysis used chi-squared test to assess statistically significant risk factors for HIV and syphilis. Logistic regression models were used to identify the most important determinants for each outcome.


RESULTS
A total of 5,958 FSWs were tested, and among them, 100 (1.7%) were HIV positive and 230 (3.9%) were syphilis positive. The multivariate analysis revealed that syphilis was higher among those street-based, aged ≥35 years, illiterate, and with a duration of sex work of >3 years. HIV was higher among those aged ≥35 years, illiterate, street-based, and with a duration of sex work >3 years. Syphilis was strongly correlated with HIV.


CONCLUSIONS
HIV epidemic among FSWs in Nepal appears in the stagnant trend, whereas STI epidemic has increased in recent years. The high influencing factors for HIV and syphilis prevalence were advanced age, street-based, lower education, and longer duration of sex work. Urgent efforts, as part of routine HIV/STI prevention and intervention, are required to reduce the high burden of syphilis among FSWs.
Department of Mathematics and Computer Science, Prince of Songkla University, Pattani, Thailand.
Sampurna
S
Kakchapati
National Centre for AIDS and STD Control, Kathmandu, Nepal.
Dipendra Raman
DR
Singh
National Centre for AIDS and STD Control, Kathmandu, Nepal.
Bir Bahadhur
BB
Rawal
Department of Mathematics and Computer Science, Prince of Songkla University, Pattani, Thailand.
Apiradee
A
Lim
IBBS; sex workers; sexual behaviors; surveillance