HIV and STI Prevalence among Female Sex Workers in Côte d'Ivoire: Why Targeted Prevention Programs Should Be Continued and Strengthened

Bea Vuylsteke,Lazare Sika,Marie Laga,Gisèle Semdé,Tania Crucitti,Virginie Ettiègne Traoré,Anne Buvé

doi:10.1371/journal.pone.0032627

Abstract

ObjectiveTo assess condom use and prevalence of STIs and HIV among female sex workers (FSWs), as part of a comprehensive monitoring and evaluation plan of a nationwide sex worker prevention project in Côte d'Ivoire.Design and MethodsCross sectional surveys were conducted among FSWs attending five project clinics in Abidjan and San Pedro (2007), and in Yamoussoukro and Gagnoa (2009). A standardized questionnaire was administered in a face-to-face interview, which included questions on socio-demographic characteristics, sexual behaviour and condom use. After the interview, the participants were asked to provide samples for STI and HIV testing.ResultsA total of 1110 FSWs participated in the surveys. There were large differences in socio-demographic and behavioural characteristics between FSW coming for the first time as compared to FSW coming on a routine visit. The prevalence of N. gonorrhoeae or C.trachomatis was 9.1%, 11.8% among first vs. 6.9% routine attendees (p = 0.004). The overall HIV prevalence was 26.6%, it was lower among first time attendees (17.5% as compared to 33.9% for routine attendees, p<0.001). The HIV prevalence among first attendees was also lower than the proportion of HIV positive tests from routine testing and counselling services in the same clinics.ConclusionsThe results show a relatively high STI and HIV prevalence among FSWs in different cities in Côte d'Ivoire. In the light of these results, prevention efforts should continue to focus on FSWs in the country.

Highlights

Sex workers and their clients are a critical group in the spread of HIV infection, in every region in the world [1]
There were large differences in socio-demographic and behavioural characteristics between female sex workers (FSWs) coming for the first time as compared to FSW coming on a routine visit
Socio-demographic and behavioural characteristics A total of 1110 FSWs participated in the surveys in 2007 and

Summary

Introduction

Sex workers and their clients are a critical group in the spread of HIV infection, in every region in the world [1]. A series of community and facility based surveys were conducted between 1991 and 1998 showing a substantial increase in condom use and a dramatic decline of HIV prevalence from 89% in 1992 to 33% in 1998 among sex workers attending the clinic for the first time [4]. The success of this project called for expansion and scaling up of both community-based and clinic-based HIV prevention activities for FSWs in Cote d’Ivoire [4]. Key indicators of the project’s success include an increase in condom use and a decrease of STI/ HIV prevalence among the target population

Methods

Results

Discussion

Conclusion