Abstract
BackgroundLimited data are available regarding correlates of regular sexually transmitted infections (STIs) and HIV screening among female sex workers (FSW) in Sub-Saharan Africa. In this study, we aimed to assess the frequency of regular syphilis and HIV screening and the psychosocial correlates associated with screening among FSW in Uganda.MethodsThis cross-sectional correlational study was conducted among 441 FSW, aged 17–49 years. We enrolled FSW through peer referrals and ascertained self-reported data on number of serological tests for HIV, syphilis and other STIs in the prior 12 months using an interviewer-administered questionnaire. In addition, we assessed attitudes, norms, social influences and self-efficacy towards 3-monthly Syphilis and 6-monthly HIV testing. We estimated the correlates of regular STI and HIV testing using negative binomial regression.ResultsOf the respondents 420 (95.2%) reported to have ever taken an HIV test with 297 (67.4%) testing two or more times in the prior 12 months. Over half of the respondents (59%) reported ever taking a syphilis test with only 62 (14.1%) reporting testing three or more times in the prior 12 months. After adjusting for socio-demographics, attitude and norms, high perceived self-efficacy was associated with a 33% increase in the likelihood of repeated HIV testing [prevalence ratio (PR), 1.33, 95% confidence interval (CI) 1.15–1.53] while low perceived confidence was associated with a 25% decrease in the likelihood of repeated HIV testing (PR, 0.75, 95% CI 0.63–0.89). Similarly low attitudes and norms were associated with a decrease of 52.6% (PR, 0.47, 95% CI 0.37–0.61) and 47% (PR, 0.53, 95% CI 0.41–0.69) in the likelihood of repeated syphilis testing respectively.ConclusionCompared to HIV, uptake of repeated syphilis testing was very low. Correlates of HIV testing include; perceived self-efficacy amidst barriers and perceived confidence for HIV and low attitudes and accepting norms for syphilis. Health campaigns should emphasize overcoming barriers to HIV testing while promoting attitudes and norms including integration of serological syphilis testing and other STIs into HIV services.
Highlights
Limited data are available regarding correlates of regular sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) screening among female sex workers (FSW) in Sub-Saharan Africa
For this paper we describe how attitude, accepting norms and self-efficacy influences the frequency of syphilis and HIV testing and our publication will describe intentions
STI and HIV testing behaviors of respondents A significant number (47.2%, n = 208) of respondents reported past medical history of syphilis (Table 2)
Summary
Limited data are available regarding correlates of regular sexually transmitted infections (STIs) and HIV screening among female sex workers (FSW) in Sub-Saharan Africa. The burden of HIV and other sexually transmitted infections (STIs) is disproportionately high among female sex workers globally [1, 2]. HIV prevalence is substantially higher among FSW in sub-Saharan Africa (SSA) (36.9%) than globally (11.8–30.7%) [2, 3]. Eastern and southern Africa is the region most affected by the HIV epidemic [4, 5], accounting for 45% of new HIV infections globally [5]. In 2017, approximately 2–8% of new HIV infections in this region occurred among sex workers and their clients [5]. FSW are a bridge population— up to 15% of HIV infections in the general female adult
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