Abstract
Background:National-level population size estimates (PSEs) for hidden populations are required for HIV programming and modelling. Various estimation methods are available at the site-level, but it remains unclear which are optimal and how best to obtain national-level estimates.Setting:Zimbabwe.Methods:Using 2015–2017 data from respondent-driven sampling (RDS) surveys among female sex workers (FSW) aged 18+ years, mappings, and program records, we calculated PSEs for each of the 20 sites across Zimbabwe, using up to 3 methods per site (service and unique object multipliers, census, and capture-recapture). We compared estimates from different methods, and calculated site medians. We estimated prevalence of sex work at each site using census data available on the number of 15–49-year-old women, generated a list of all “hotspot” sites for sex work nationally, and matched sites into strata in which the prevalence of sex work from sites with PSEs was applied to those without. Directly and indirectly estimated PSEs for all hotspot sites were summed to provide a national-level PSE, incorporating an adjustment accounting for sex work outside hotspots.Results:Median site PSEs ranged from 12,863 in Harare to 247 in a rural growth-point. Multiplier methods produced the highest PSEs. We identified 55 hotspots estimated to include 95% of all FSW. FSW nationally were estimated to number 40,491, 1.23% of women aged 15–49 years, (plausibility bounds 28,177–58,797, 0.86–1.79%, those under 18 considered sexually exploited minors).Conclusion:There are large numbers of FSW estimated in Zimbabwe. Uncertainty in population size estimation should be reflected in policy-making.
Highlights
Objectives1. To review methods to estimate population sizes of marginalised populations such as female sex workers 2
Workshop attendees attended training on methods used to estimate population sizes, their strengths, weaknesses and uncertainties, estimates obtained from 20 sites in Zimbabwe, and methods used to extrapolate site estimates to the national level
The facilitators asked participants to put forward suggestionsthese were each discussed and debated, a consensus amongst workshop attendees was reached and participants were reminded of the decisions reached at regular intervals and at the end of the workshop
Summary
1. To review methods to estimate population sizes of marginalised populations such as female sex workers 2. To review female sex worker population size estimates (PSEs) for 20 sites across Zimbabwe 3.
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