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Safer conception needs for HIV prevention among female sex workers in Burkina Faso and Togo.

Schwartz SR, Papworth E, Ky-Zerbo O, Anato S, Grosso A, Ouedraogo HG, Ketende S, Pitche VP, Baral S - Infect Dis Obstet Gynecol (2014)

Bottom Line: Reproductive health programming for female sex workers (FSW) may include contraceptive services but rarely addresses safer pregnancy planning.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.Programs to facilitate earlier HIV diagnosis for FSW and safer conception counseling are needed as components of effective combination HIV prevention services.

View Article: PubMed Central - PubMed

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.

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.

Conclusion: 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.

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Related in: MedlinePlus

HIV prevention and risk behaviors among female sex workers trying to conceive (n = 267).
© Copyright Policy - open-access
Related In: Results  -  Collection


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fig1: HIV prevention and risk behaviors among female sex workers trying to conceive (n = 267).

Mentions: FSW trying to conceive trended to more frequently report unprotected vaginal sex with nonpaying partner(s) in the past month as compared to FSW who also had nonpaying partner(s) but were not trying to conceive (77.9% versus 70.6%, resp., P = 0.06). Limited to the subset of FSW trying to conceive, Figure 1 further demonstrates the frequency of reported behaviors that elevate or mitigate HIV-related risks in the periconception period. Among FSW trying to conceive, the proportion of women reporting unprotected vaginal sex acts with nonpaying partners was similar between women living with and without HIV (76.6% versus 78.5%, P = 0.92). Around 12% of women reported unprotected anal sex with their nonpaying partners in the past month as well. Overall in the Chi-squared analyses assessing periconception behaviors that increase HIV transmission, reporting multiple nonpaying partners was the only risk behavior associated with HIV infection status among women trying to conceive. FSW living with HIV were less likely to report multiple nonpaying partners as compared to HIV-uninfected FSW. This may suggest that FSW known to be living with HIV reduce the number of their nonpaying partners to minimize onward transmission risk, while HIV-uninfected FSW may take greater personal risks in order to become pregnant. In terms of behaviors known to mitigate risk, HIV-infected and uninfected women were similar. Just over one-third of women had talked to their sexual partners in the past month about their HIV infection status, and slightly more women had talked to their nonpaying partners about his HIV infection status. History of ever testing for HIV was comparable between HIV-infected (79.4%) and -uninfected (74.4%, P = 0.40) women who were trying to conceive, as was consistent condom use during sex acts with clients (82.5% and 74.5%, resp., P = 0.19).


Safer conception needs for HIV prevention among female sex workers in Burkina Faso and Togo.

Schwartz SR, Papworth E, Ky-Zerbo O, Anato S, Grosso A, Ouedraogo HG, Ketende S, Pitche VP, Baral S - Infect Dis Obstet Gynecol (2014)

HIV prevention and risk behaviors among female sex workers trying to conceive (n = 267).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4227409&req=5

fig1: HIV prevention and risk behaviors among female sex workers trying to conceive (n = 267).
Mentions: FSW trying to conceive trended to more frequently report unprotected vaginal sex with nonpaying partner(s) in the past month as compared to FSW who also had nonpaying partner(s) but were not trying to conceive (77.9% versus 70.6%, resp., P = 0.06). Limited to the subset of FSW trying to conceive, Figure 1 further demonstrates the frequency of reported behaviors that elevate or mitigate HIV-related risks in the periconception period. Among FSW trying to conceive, the proportion of women reporting unprotected vaginal sex acts with nonpaying partners was similar between women living with and without HIV (76.6% versus 78.5%, P = 0.92). Around 12% of women reported unprotected anal sex with their nonpaying partners in the past month as well. Overall in the Chi-squared analyses assessing periconception behaviors that increase HIV transmission, reporting multiple nonpaying partners was the only risk behavior associated with HIV infection status among women trying to conceive. FSW living with HIV were less likely to report multiple nonpaying partners as compared to HIV-uninfected FSW. This may suggest that FSW known to be living with HIV reduce the number of their nonpaying partners to minimize onward transmission risk, while HIV-uninfected FSW may take greater personal risks in order to become pregnant. In terms of behaviors known to mitigate risk, HIV-infected and uninfected women were similar. Just over one-third of women had talked to their sexual partners in the past month about their HIV infection status, and slightly more women had talked to their nonpaying partners about his HIV infection status. History of ever testing for HIV was comparable between HIV-infected (79.4%) and -uninfected (74.4%, P = 0.40) women who were trying to conceive, as was consistent condom use during sex acts with clients (82.5% and 74.5%, resp., P = 0.19).

Bottom Line: Reproductive health programming for female sex workers (FSW) may include contraceptive services but rarely addresses safer pregnancy planning.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.Programs to facilitate earlier HIV diagnosis for FSW and safer conception counseling are needed as components of effective combination HIV prevention services.

View Article: PubMed Central - PubMed

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.

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.

Conclusion: 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.

Show MeSH
Related in: MedlinePlus