Female sex workers population size estimation in Rwanda using a three-source capture−recapture method

G Musengimana,R H Doshi,E Remera,A Mulindabigwi,E Kayirangwa,P Mugwaneza,D Sebuhoro,S Gutreuter,E Tuyishime,M Dong,D Prybylski,V Mutarabayire,S Nsanzimana,S S Malamba,C Kayitesi

doi:10.1017/s0950268821000595

Abstract

Establishing accurate population size estimates (PSE) is important for prioritising and planning provision of services. Multiple source capture-recapture sampling method increases PSE accuracy and reliability. In August 2018, the three-source capture-recapture (3S-CRC) method was employed with a stringent assumption of sample independence to estimate the number of female sex workers (FSW) in Rwanda. Using Rwanda 2017 FSW hotspots mapping data, street and venue-based FSW were sampled at the sector level of each province and tagged with two unique gifts. Each capture was completed within one week to minimise FSW migration between provinces and recall bias. The three captures had 1042, 1204 and 1488 FSW. There were 111 FSW recaptured between captures 1 and 2; 237 between captures 2 and 3; 203 between captures 1 and 3 and 46 captured in all three. The PSE for street and venue-based FSW in Rwanda lies within 95% credible set: 8328-22 806 with corresponding median of 13 716 FSW. The 3S-CRC technique was low-cost and relatively easy to use for PSE in hard-to-reach populations. This estimate provides the basis for determining the denominators to assess HIV programme performance towards FSW and epidemic control and warrants further PSE for home- and cyber-based FSW in Rwanda.

Highlights

Persons who exchange sex for money and other non-monetary items are at high risk of acquiring and transmitting HIV and other sexually transmitted infections
The 2014 report from Joint United Nations Programme on HIV/AIDS (UNAIDS) stated that the prevalence of HIV among female sex workers (FSW) was higher than the highest national value of HIV prevalence among the general population in nine countries including eSwatini, Botswana and Rwanda [4]
We evaluated the sensitivity of the estimates of population size to hyperprior choices given by the beta (1, 1), beta (0.5, 0.5) (Jeffrey’s prior), beta (5, 5), beta (1, 5) and beta (5, 1) distributions the stick-breaking process which contains the number of latent classes

Summary

Introduction

Persons who exchange sex for money and other non-monetary items are at high risk of acquiring and transmitting HIV and other sexually transmitted infections. This risk is high for those who exchange unprotected sex as their main source of income, such as female sex workers (FSW) [1]. HIV prevalence remains high among key populations, especially FSW [7]. The 2015 national bio-behavioural survey (BBS) reported that HIV prevalence has disproportionately affected FSWs (45.8%) in Rwanda, especially those from the capital city, Kigali (55.5%) [8]. It is essential to establish accurate population size estimates (PSE), in order to understand the magnitude and burden of HIV epidemic among FSWs to inform HIV prevention and treatment and guide resource allocation to this key population [9, 10]

Methods

Results

Conclusion