HIV risk practices by female sex workers according to workplace.

Giseli Nogueira Damacena,Paulo Roberto Borges De Souza Júnior,Célia Landmann Szwarcwald

doi:10.1590/s0034-8910.2014048004992

Giseli Nogueira Damacena, Paulo Roberto Borges De Souza Júnior + Show 1 more

Open Access

https://doi.org/10.1590/s0034-8910.2014048004992

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Abstract

OBJECTIVE To investigate differences in HIV infection- related risk practices by Female Sex Workers according to workplace and the effects of homophily on estimating HIV prevalence.METHODS Data from 2,523 women, recruited using Respondent-Driven Sampling, were used for the study carried out in 10 Brazilian cities in 2008-2009. The study included female sex workers aged 18 and over. The questionnaire was completed by the subjects and included questions on characteristics of professional activity, sexual practices, use of drugs, HIV testing, and access to health services. HIV quick tests were conducted. The participants were classified in two groups according to place of work: on the street or indoor venues, like nightclubs and saunas. To compare variable distributions by place of work, we used Chi-square homogeneity tests, taking into consideration unequal selection probabilities as well as the structure of dependence between observations. We tested the effect of homophily by workplace on estimated HIV prevalence.RESULTS The highest HIV risk practices were associated with: working on the streets, lower socioeconomic status, low regular smear test coverage, higher levels of crack use and higher levels of syphilis serological scars as well as higher prevalence of HIV infection. The effect of homophily was higher among sex workers in indoor venues. However, it did not affect the estimated prevalence of HIV, even after using a post-stratification by workplace procedure.CONCLUSIONS The findings suggest that strategies should focus on extending access to, and utilization of, health services. Prevention policies should be specifically aimed at street workers. Regarding the application of Respondent-Driven Sampling, the sample should be sufficient to estimate transition probabilities, as the network develops more quickly among sex workers in indoor venues.

Highlights

It is necessary to monitor the practices and attitudes of those most at risk of HIV infection, as specific interventions aimed at these population subgroups can significantly alter the pattern of the spread of HIV and AIDS in the general population.[5]Research on female sex workers (FSW) confirms the increased risk of HIV infection in this population subgroup
The findings suggest that strategies should focus on extending access to, and utilization of, health services
Practices placing them at risk of HIV infection may vary according to where the FSW meet their clients.[4,7,20,21]

Summary

Introduction

Research on female sex workers (FSW) confirms the increased risk of HIV infection in this population subgroup. Lack of access to health care services, drug abuse and prior history of sexually transmitted infection have been shown, and are factors associated with HIV prevalence.[20,23] Recent studies emphasize the importance of characterizing FSW practice according to workplace. Practices placing them at risk of HIV infection may vary according to where the FSW meet their clients (indoor venues or on the street).[4,7,20,21]. Convenience sampling was used in studies of this type, due to the difficulties in using traditional sampling techniques to select individuals in populations with high risk of HIV infection.[25] These studies were local, limiting monitoring of national level prevention actions and policies.[3]

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