Abstract
Background: In Cambodia, behavioral risks and subsequent new HIV infections in key populations, including female entertainment workers (FEWs), continue to be of great national concerns. This National Integrated Behavioral and Biological Survey was conducted to determine the prevalence of HIV, syphilis, and related risk behaviors among FEWs in the country. Methods: This cross-sectional survey was conducted in 2016 among 3,151 venue-based and non-venue-based FEWs recruited from the capital city and 17 other provinces using a two-stage cluster sampling design for structured-questionnaire interviews and HIV/syphilis testing. Descriptive statistical analyses were performed. Results: The mean age of FEWs in this survey was 26.2 (SD= 5.7) years. The prevalence of HIV and syphilis was 3.2% (95% CI= 1.75-5.75) and 0.8% (95% CI= 0.36-1.70), respectively. Only 25.1% of the respondents reported always using condoms with non-commercial partners, and 80.6% reported always using condoms with commercial partners in the past three months. About one-fifth (20.2%) reported having had at least one STI symptom in the past three months. Regarding substance use, 7.6% reported having used some form of illicit drugs in the past three months. The most common form of the drugs was amphetamine-type stimulants (86.1%), and 0.6% reported injecting drugs in the past three months. Of the total, 74.3% reported using some form of contraceptives, with condoms being the most common method (33.5%), and 33.7% reported having at least one induced abortion during the time working as an EW. Conclusions: This study surmises that the prevalence of HIV among FEWs in Cambodia remains stable, and these women remain at an increased risk of HIV infection. Sexual behaviors, notably inconsistent condom use and multiple partnership, may have exacerbated their vulnerability. These findings highlight the need for tailor-made interventions that focus on sexual and reproductive health education and access to needed services for this key population.
Highlights
More than 20 years ago, Cambodia was one of the countries with the highest prevalence of human immunodeficiency virus (HIV) in Asia and the pacific [1,2]
We found that the prevalence of HIV among female entertainment workers (FEWs) in this study remained relative high compared to the prevalence in the general adult population in the country (3.2% vs. 0.3%) [7]
As reported in previous national surveys conducted by NCHADS, the prevalence among both brothel-based and non-brothel-based female sex workers remained high at 37.3% and 17.4%, respectively in 2011, a constant decline has been observed in the last decade [1,6]
Summary
More than 20 years ago, Cambodia was one of the countries with the highest prevalence of human immunodeficiency virus (HIV) in Asia and the pacific [1,2]. A decade later, the country became one of the few countries in the world that has reversed the epidemic from being generalized to concentrated, thanks to the combined efforts of the national programs, civil societies, and development partners [3] In recognition of these successes, Cambodia received a Millennium. In Cambodia, behavioral risks and subsequent new HIV infections in key populations, including female entertainment workers (FEWs), continue to be of great national concerns. This National Integrated Behavioral and Biological Survey was conducted to determine the prevalence of HIV, syphilis, and related risk behaviors among FEWs in the country. These findings highlight the need for tailor-made interventions that focus on sexual and reproductive health education and access to needed services for this key population
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