Safer conception needs for HIV prevention among female sex workers in Burkina Faso and Togo.

Sheree R Schwartz,Odette Ky-Zerbo,Erin Papworth,Simplice Anato,Henri Gautier Ouedraogo,Stefan Baral,Vincent Palokinam Pitche,Sosthenes Ketende,Ashley Grosso

doi:10.1155/2014/296245

Sheree R Schwartz, Odette Ky-Zerbo + Show 7 more

Open Access

https://doi.org/10.1155/2014/296245

Copy DOI

Abstract

Background. Reproductive health programming for female sex workers (FSW) may include contraceptive services but rarely addresses safer pregnancy planning. Methods. Adult FSW were enrolled into a cross-sectional study across four sites in Burkina Faso and Togo using respondent-driven sampling. Sociobehavioral questionnaires and HIV counseling and testing were administered. Sample statistics and engagement in HIV treatment were described and compared using Chi-squared statistics. Results. 1,349 reproductive-aged FSW were enrolled from January to July 2013. Overall, 267 FSW (19.8%) were currently trying to conceive. FSW trying to conceive were more likely to test positive for HIV at enrollment as compared to women not trying to become pregnant (24.5% versus 17.7%, P < 0.01); however awareness of HIV status was similar across groups. Among FSW trying to conceive, 79.0% (211/267) had previously received HIV testing, yet only 33.8% (23/68) of HIV-infected FSW reported a previous HIV diagnosis. Overall 25.0% (17/68) of HIV-infected FSW trying to conceive were on antiretroviral therapy. Conclusion. FSW frequently desire children. However engagement in the HIV prevention and treatment cascade among FSW trying to conceive is poor potentiating periconception transmission risks to partners and infants. Programs to facilitate earlier HIV diagnosis for FSW and safer conception counseling are needed as components of effective combination HIV prevention services.

Highlights

Reproductive health programming for female sex workers (FSW) has traditionally emphasized contraception, including condom use for both pregnancy and HIV prevention, and screening and treatment of sexually transmitted infections [1,2,3,4]
As FSW are disproportionately affected by HIV, safer conception approaches are relevant for FSW trying to become pregnant, in order to minimize periconception HIV infection and superinfection risks among FSW, to minimize onward transmission risks to partners of FSW living with HIV and to reduce risks to infants [19]
Seed selection took into account seed characteristics in order to ensure that a range of ages, years engaged in sex work, countries of origin, education, marital status, and languages spoken were represented

Summary

Introduction

Reproductive health programming for female sex workers (FSW) has traditionally emphasized contraception, including condom use for both pregnancy and HIV prevention, and screening and treatment of sexually transmitted infections [1,2,3,4]. While these are critical components of reproductive health programming, fertility is of great importance in SubSaharan Africa [5,6,7], and there is growing evidence that FSW, like other women, desire children [8,9,10]. Programs to facilitate earlier HIV diagnosis for FSW and safer conception counseling are needed as components of effective combination HIV prevention services

Methods

Results

Discussion

Conclusion