Female Sex Workers In Nigeria Research Articles

Sexual Practices and HIV Prevention Strategies Used by Female Sex Workers in Lagos, Nigeria: An Assessment of the Willingness to Use a Microbicide.

Female sex workers have a 13-fold higher risk of acquiring HIV than women who do not engage in sex work. The willingness and acceptability of a product is crucial for the development of microbicides. This research aimed to evaluate the sexual practices, existing HIV prevention methods, and willingness to use a microbicide for HIV prevention among female sex workers in Nigeria. We also explored factors that might influence their willingness to use a new microbicide product. A cross-sectional study was conducted among female sex workers recruited from brothels within Lagos-Nigeria, in which participants were selected via purposive sampling over a period of five-months. An interviewer-administered, semi-structured questionnaire was used to obtain information. Descriptive statistics were used to present the results, and a multiple logistic regression model was used to determine the factors associated with willingness to use a microbicide. A total of 461 female participants with a mean-age of 29.63 ± 8.8 years were included in the analysis of which 34.3% had >4 sexual partners, 91.8% used condoms, 53.6% engaged in anal sex, 69.6% had experienced condom rupture, and 31% would "accept unprotected sex" if the male partner refuses to use a condom. Approximately 43% had received PEP, of which only 15% completed the one-month PEP-regimen. On the other hand, 64.6% had taken PrEP medications, of which 28% admitted skipping doses. Although 41% were concerned about male partner acceptance, a total of 95% will be willing to use a microbicide. The number of sexual partners ([aOR] 1.555; 95% Cl 1.035-2.335), use of condoms ([aOR] 4.701; 95% Cl 1.418-15.584), and condom rupture experience ([aOR] 2.550; 95% Cl 1.817-7.959) were associated with greater odds of willingness to use an HIV microbicide. There is a high level of willingness to use a future microbicide among the female commercial sex workers in this study. In addition, majority of the participants will prefer a microbicide product that is female controlled, affordable, and provided as an over-the-counter medication. This cohort of women engage in high-risk sexual practices and play a significant role in HIV prevention efforts. Therefore, their product preferences and concerns should be considered in microbicide development to enhance the acceptability, adherence, and efficacy of future microbicides.

Prevalence and correlates of prenatal HIV testing among female sex workers in Nigeria.

Female sex workers (FSWs) face a significant and persistent risk of contracting HIV. While evidence indicates high rates of pregnancy among FSWs in sub-Saharan Africa, studies on the coverage of HIV testing during pregnancy among them are sparse. The objective of this study was to estimate the prevalence of prenatal HIV testing and determine the associated factors among FSWs in Nigeria. This study was a secondary data analysis of the 2020 Integrated Biological & Behavioural Surveillance Survey (IBBSS) among key populations in Nigeria. We performed weighted descriptive statistics and multivariable binary logistic regression to assess the associations between prenatal HIV testing and sociodemographic characteristics, risk behaviours, HIV knowledge and risk awareness, stigma, and access to healthcare. Of the 1598 FSWs included in the study, 71.0% (95%CI = 68.7%-73.1%) had HIV testing during their last pregnancy. In the regression model, tertiary education (aOR = 2.98, 95%CI = 1.48-6.01), consistent condom use (aOR = 1.95, 95%CI = 1.39-2.75), and receipt of antenatal care (aOR = 35.52, 95%CI = 23.40-53.92) were associated with higher odds of prenatal HIV testing. Compared with the South South geopolitical zone, FSW residing in South East (aOR = 3.38, 95%CI = 1.80-6.35), South West (aOR = 2.97, 95%CI = 1.88-4.68), North Central (aOR = 4.43, 95%CI = 2.80-7.01), North East (aOR = 4.22, 95%CI = 1.64-10.34), North West (aOR = 4.40, 95%CI = 2.59-7.48) had higher odds of reporting prenatal HIV testing. However, being a non-brothel-based FSW (aOR = 0.66, 95%CI = 0.47-0.92), and engaging in sex work during pregnancy (aOR = 0.45, 95%CI = 0.31-0.66) were significantly associated with lower odds of prenatal HIV testing. The prenatal HIV testing among FSWs in this study was suboptimal. The results highlight the need to improve access to antenatal care and implement regional and typology-specific interventions to bridge the gap in prenatal HIV testing among FSWs.

Factors associated with viral load testing and viral suppression among HIV-positive female sex workers in Nigeria.

Female sex workers (FSWs) are at high risk for HIV infection and face unique barriers to receiving and adhering to testing and treatment. Early viral suppression and consistent viral load testing are critical to optimizing health and reducing transmission in this population. However, the factors associated with testing and successful viral suppression among FSWs are poorly understood, especially in Sub-Saharan Africa. Our study aimed to examine factors, including social, demographic, and clinical characteristics, associated with viral load testing and suppression among female sex workers initiating antiretroviral therapy in Nigeria. In this retrospective study, we analyzed routine programmatic data from FSWs enrolled in the National HIV Key Populations (KP) program in Nigeria. We included FSWs who were newly diagnosed with HIV and registered between January 2016 and January 2022. Primary outcomes of interest were a), receiving a viral load test at any point after treatment initiation and b), viral suppression (<1000 copies/ml) at the test closest to 6 months after treatment initiation. To identify factors associated with the outcomes of interest, we used univariable and multivariable logistic regression, with random intercepts for care facilities, and multiple imputation for missing values. Out of 34,976 FSWs, 97.1% (n = 33,945) received at least one viral load test, with 94.5% (n = 32,092) indicating viral suppression. The odds of receiving at least one viral load test were higher for those who entered treatment in more recent years, those with formal education and those with advanced HIV stages at baseline (adjusted odds ratios [aOR]: 1.17 [1.14-1.19] for those who entered treatment in 2020 vs. 2016; 1.02 [1.01-1.03] for post-secondary vs. no education; and 1.05 [1.01-1.10] for WHO clinical stage 3/4 vs. stage 1 respectively). The odds of successful viral suppression were higher for those who entered treatment in more recent years, but lower for those with advanced HIV stages at baseline (aOR: 1.13 [1.09-1.18] for 2022 vs. 2016; and 0.92 [0.87-0.98] for WHO clinical stage 3/4 vs. stage 1 respectively). The study underscored the relevance of timely diagnosis and ART initiation for optimal outcomes among HIV-positive FSWs in Nigeria. We also observed significant improvements in the likelihood of early viral load testing and suppression over the study period, reflecting advancements in the KP program. Further research should clarify factors driving these trends to further strengthen the HIV care pipeline for female sex workers.

Gender-based violence against female sex workers in Nigeria: how helpful are grassroot interventions?

Introduction: Gender-based violence (GBV) against female sex workers (FSWs) increases their risk of unwanted pregnancies, abortion, HIV, and other sexually transmitted infections (STIs). Hence, this study aims to assess the impacts of grassroots interventions on GBV against FSW in Benue State, Nigeria. Methods: The study is a cross-sectional baseline-post-intervention survey using a randomized cluster sampling technique. It was carried out in six local governments of the State using structured questionnaires to collect data from the respondents. Data were analyzed using IBM Statistical Package for the Social Science (SPSS) version 25.0. Results: This study comprised 446 FSWs with 223 from each baseline and intervention survey. The prevalence of GBV was 48.0% in the baseline and 59.2% in the intervention (P&lt;0.001). The most common GBV were being beaten/battered/kicked (26.0%) in the baseline and 30.9% in the intervention (P&gt;0.05). Paying partners (65.6%), the police (53.0%), and vigilantes (30.3%) were the top perpetrators of GBV in the post-intervention study, higher than 41.3%, 17.5%, and 3.9% in the baseline (P&lt;0.001). Access to health care services after GBV was 43.0% in the baseline and 72.7% in the intervention (P&lt;0.001). Only 24.2% of post-intervention respondents would keep cases of GBV to themselves instead of reporting them to appropriate authorities, compared to 53.3% in baseline (P&lt;0.001). Conclusion: The study recorded higher reports of GBV among the FSWs after the intervention than at the baseline, in which most cases of GBV were underreported. The increased ability to report cases among FSWs after intervention helped to improve the boldness of the victims in reporting the GBV.

Costs of HIV prevention services provided by community-based organizations to female sex workers in Nigeria.

Nigeria has been consistently targeted in sub-Saharan Africa as an HIV-priority country. Its main mode of transmission is heterosexual, and consequently, a key population of interest is female sex workers (FSWs). While HIV prevention services are increasingly implemented by community-based organizations (CBOs) in Nigeria, there is a paucity of evidence on the implementation costs of these organizations. This study seeks to fill this gap by providing new evidence about service delivery unit cost for HIV education (HIVE), HIV counseling and testing (HCT), and sexually transmitted infection (STI) referral services. In a sample of 31 CBOs across Nigeria, we calculated the costs of HIV prevention services for FSWs taking a provider-based perspective. We collected 2016 fiscal year data on tablet computers during a central data training in Abuja, Nigeria, in August 2017. Data collection was part of a cluster-randomized trial examining the effects of management practices in CBOs on HIV prevention service delivery. Staff costs, recurrent inputs, utilities, and training costs were aggregated and allocated to each intervention to produce total cost calculations, and then divided by the number of FSWs served to produce unit costs. Where costs were shared across interventions, a weight proportional to intervention outputs was applied. All cost data were converted to US dollars using the mid-year 2016 exchange rate. We also explored the cost variation across the CBOs, particularly the roles of service scale, geographic location, and time. The average annual number of services provided per CBO was 11,294 for HIVE, 3,326 for HCT, and 473 for STI referrals. The unit cost per FSW tested for HIV was 22 USD, the unit cost per FSW reached with HIV education services was 19 USD, and the unit cost per FSW reached by STI referrals was 3 USD. We found heterogeneity in total and unit costs across CBOs and geographic location. Results from the regression models show that total cost and service scale were positively correlated, while unit costs and scale were consistently negatively correlated; this indicates the presence of economies of scale. By increasing the annual number of services by 100 percent, the unit cost decreases by 50 percent for HIVE, 40 percent for HCT, and 10 percent for STI. There was also evidence that indicates that the level of service provision was not constant over time across the fiscal year. We also found unit costs and management to be negatively correlated, though results were not statistically significant. Estimates for HCT services are relatively similar to previous studies. There is substantial variation in unit costs across facilities, and evidence of a negative relationship between unit costs and scale for all services. This is one of the few studies to measure HIV prevention service delivery costs to female sex workers through CBOs. Furthermore, this study also looked at the relationship between costs and management practices-the first of its kind to do so in Nigeria. Results can be leveraged to strategically plan for future service delivery across similar settings.

Predictors and screening of cervical cancer among HIV positive transactional female sex workers in Nigeria

Introduction: In middle and low income regions of the world, there are approximately 90% of cervical cancer deaths. Factors contributing to the striking disproportionate cancer burden in the developing countries as opposed to the developed countries may include lack of effective large scale preventive interventions such as Cytology based screening programs, Visual Inspection with acetic acid (VIA) that emphasize patient education, accessible diagnostic treatment centres and established vaccination programs especially among Most at risk populations like female sex workers (FSWs). Methodology: The study was conducted in Calabar, South-Southern Nigeria. Calabar is a port city near the Cameroon border. This is a cross sectional retrospective study among 124 Human Immune Virus (HIV)Positive female sex workers receiving ART services, in which secondary data was obtained from the Clinic Data repository for a periodspanning from October 2018- October 2019. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 22. Result: 36.30% of the respondents are between the ages of 21-30 years, 78.20% had 0-4 sexual partners, and 76.60% of the respondents use condom. 89.50% were virally suppressed while 3.20% of the study population tested positive to cervical cancer. In the regression analysis, there were non-significant negative correlation linking Age, Parity groups and viral suppression to cervical cancer, and a positive non-significant correlation linking sex partners, smoking, previous STI and educational status to cervical cancer. However, a positive significant correlation was noted between family planning method and risk of cervical cancer. Conclusion: HIV-positive Nigerian FSWs are at marginally increased risk for cervical pre-cancer and cancer. The ‘screen and treat approach’ using VIA had been shown to be effective for the detection of cervical pre-cancer and cancer, and has shown to reduce loss to follow-up. This should be rapidly incorporated into HIV-treatment programs in resource-constraint settings.

Predictors and screening of cervical cancer among HIV positive transactional female sex workers in Nigeria

Predictors and screening of cervical cancer among HIV positive transactional female sex workers in Nigeria

Oral, genital and anal human papillomavirus infections among female sex workers in Ibadan, Nigeria.

BackgroundThere are limited data on the epidemiology of HPV in different anatomical sites of female sex workers (FSW). We investigated the prevalence and concordance of cervical, vulval, oral and anal HPV among FSW in Ibadan, Nigeria.MethodsFSWs aged 18–45 years were enrolled in a cross-sectional survey. After interview and clinical examination, samples were collected from mouth, cervix, vulva and anus. HPV genotyping was done with Anyplex II 28HPV assay. Multivariable analyses were performed to explore associated risk factors and concordance of HPV infections across sites.ResultsIn total, 315 FSWs participated in the study with a mean age of 30–6.5 years. The prevalence of any HPV infection was 88% in the vulva, 84% in the cervix, 75% in the anus and 24% in the oral cavity. HPV 35 was the most prevalent and concordant high-risk type in the four sites. The risk factors for HPV infection by anatomic site varied.ConclusionThis large study showed a high prevalence and concordance of HPV infections of cervical, vulval, oral and anal HPV among FSWs in Nigeria. The potential to acquire and transmit HPV is high in this population, and we highlighted the urgency to protect young women through HPV vaccination.

Grassroots sexual and reproductive rights interventions on sexual risk behavior among female sex workers in Nigeria

Introduction: Sexual reproductive health and rights (SRHR) involve access to accurate information, rights-based quality, safe, effective, affordable, and acceptable health-care services at all levels that cover the sexual and reproductive needs of the individual and community irrespective of social, sex, gender, and other differences. Objective: This study aims at assessing the grassroots interventions on the knowledge of rights, access, and uptake of sexual reproductive health (SRH) services among female sex workers (FSWs) in Benue State, Nigeria. Materials and Methods: This cross-sectional survey is a randomized cluster sampling among FSWs in Benue State, Nigeria. A structured questionnaire was used to collect data from the respondents, and the data collected were analyzed using IBM-SPSS Corp., Armonk, NY, version 25.0. The statistical significance level was set at P &lt; 0.05. Results: Respondents were 446 FSWs aged 15–45 years, comprising 223 FSWs at baseline and post-intervention. Significantly higher intervention respondents (84.4%) use condoms while drunk compared with 56.1% at the baseline (P &lt; 0.0001). Overall, 70.0% used lubricants in the past 12 months in the post-intervention study, whereas only 47.5% used them in the baseline study (P &lt; 0.0001). Generally, 21.1% indulged in anal sex, and there was no significant difference between the baseline and intervention (P &gt; 0.05). Virtually all respondents (96.0%) used any contraceptive methods in the intervention period compared with 68.6% at the baseline (P &lt; 0.001). The intervention respondents were 11.84 (95% CI: 4.98–28.16; P &lt; 0.0001) times more likely to use any contraceptive method than their baseline counterparts. The intervention respondents were 2.22 (95% CI: 1.51–3.27; P &lt; 0.0001) times more likely to use emergency contraceptives than their baseline counterparts. Conclusion: This study showed the positive outcomes of grassroots interventions involving FSWs in Benue State, Nigeria. Such interventions should be extended to other key populations in Nigeria.

The role of management on costs and efficiency in HIV prevention interventions for female sex workers in Nigeria: a cluster-randomized control trial

BackgroundWhile the world has made much global progress toward the reduction of new HIV infections, HIV continues to be an important public health problem. In the face of constantly constrained resources, donors and grantees alike must seek to optimize resources and deliver HIV services as efficiently as possible. While there is evidence that management practices can affect efficiency, this has yet to be rigorously tested in the context of HIV service delivery.MethodsThe present protocol describes the design of a cluster-randomized control trial to estimate the effect of management practices on efficiency. Specifically, we will evaluate the impact of an intervention focused on improving management practices among community-based organizations (CBOs), on the costs of HIV prevention services for female sex workers (FSW) in Nigeria. To design the intervention, we used a qualitative, design thinking-informed methodology that allowed us to understand management in its organizational context better and to develop a user-centered solution. After designing the suite of management tools, we randomly assigned 16 CBOs to the intervention group, and 15 CBOs to the control group. The intervention consisted of a comprehensive management training and a management “toolkit” to support better planning and organization of their work and better communication between CBOs and community volunteers. Both treatment and control groups received training to record data on efficiency—inputs used, and outputs produced. Both groups will be prospectively followed through to the end of the study, at which point we will compare the average unit cost per FSW served between the two groups using a quasi-experimental “difference-in-differences” (DiD) strategy. This approach identifies the effect of the intervention by examining differences between treatment and control groups, before and after the intervention thus accounting for time-constant differences between groups. Despite the rigorous randomization procedure, the small sample size and diversity in the country may still cause unobservable characteristics linked to efficiency to unbalanced between treatment and control groups at baseline. In anticipation of this possibility, using the quasi-experimental DiD approach allows any baseline differences to be “differenced out” when measuring the effect.DiscussionThis study design will uniquely add to the literature around management practices by building rigorous evidence on the relationship between management skills and practices and service delivery efficiency. We expect that management will positively affect efficiency. This study will produce valuable evidence that we will disseminate to key stakeholders, including those integral to the Nigerian HIV response.Trial registration This trial has been registered in Clinical Trials (NCT03371914). Registered 13 December 2018

HIV prevalence and high-risk behaviour of young brothel and non-brothel based female sex workers in Nigeria

BackgroundFemale sex workers (FSWs) have been identified as a core group in the transmission of HIV and other sexually transmitted infections (STIs). Young FSWs are particularly more vulnerable to HIV due to the combination of vulnerabilities associated with their youth and the sex work they engage in. This study aims to give more insight into HIV prevalence and sexual risk behaviour of young FSWs in Nigeria, by focusing on the differences between BB and NBB young FSWs.MethodsData was obtained from the Nigeria Integrated Biological and Behavioural Surveillance Survey (IBBSS) for high-risk groups conducted in 2010. IBBSS is a quantitative survey conducted amongst identified high-risk sub populations within Nigeria. HIV prevalence and risk behaviour data for young BB and NBB FSWs aged 15–24 years for nine states was extracted and analysed.ResultsA total of 1796 FSWs aged 15–24 years were interviewed during the survey, 746 (41.5%) were BB while 1050 (58.5%) were NBB. The HIV prevalence was higher among BB FSWs compared to the NBB FSWs (21.0% vs. 15.5%). BB FSWs reported less condom use with boyfriends and casual partners than NBB FSWs (26.3% vs. 45.5%) and (55.1% vs. 61.1%) respectively while risk of HIV infection due to injecting drug use was higher in NBB compared to BB FSWs (6.6% vs. 1.2%).ConclusionExisting and future interventions on HIV prevention should focus on empowering young FSWs with innovative and sustainable approaches aimed at improving their health and wellbeing.

Diverse genetic subtypes of HIV-1 among female sex workers in Ibadan, Nigeria

Genetic diversity is the hallmark of HIV-1 infection. It differs among geographical regions throughout the world. This study was undertaken to identify the predominant HIV-1 subtypes among infected female sex workers (FSWs) in Nigeria. Methods: Two hundred and fifty FSWs from brothels in Ibadan Nigeria were screened for HIV antibody using ELISA. All reactive samples were further tested by the Western Blot Techniques. Peripheral Blood Mononuclear Cells (PBMCs) were separated from the blood samples of each subject. Fragments of HIV Proviral DNA was amplified and genetic subtypes of HIV-1 was determined by direct sequencing of the env and gag genes of the viral genome followed by phylogenetic analysis . Results: The age of the FSWs ranged from 15 to 55 years old (Mean = 25.8years, SD =3.74). Majority were Nigerians while others (1.6 %) were from neighboring West Africa countries. Four ( 1.6% ) of the FSWs were active for less than one year as sex workers, and the mean length of sex work was 2.80 years ( Range = 1.0 – 15.0 years ). Sixty-four (25.6%) of the 250 CSWs were positive for HIV-1 while 7 (2-8%) had dual infections to HIV-1 / HIV-2. Among the 34 HIV-1 strains characterized by sequencing, 19 (55-9%) were subtype G, 9 (26.5%) CRF02_A/G, 3 (8.8%) CRF06_cpx while 1 (2.9%) each were identified as subtype C, CRF01_A/E and CRF09_cpx respectively. Nineteen (55.9%) of the FSWs with subtype G had been active in the sex work for between one to five years. The youngest of the HIV -1 infected FSWs with sexual activity of less than a year had subtype G strain. There is a significant probability that infection with this subtype occurred with a short incubation period (p< 0.05). Conclusion: This study showed a wide range of HIV- 1 subtypes among FSWs in Nigeria. The situation poses serious challenge for the design of HIV vaccine candidate for use in Nigeria. Keywords : Diverse, HIV, subtypes, Female Sex workers and Vaccine

O13.1 The Use of Rapid Epidemic Appraisals For Planning and Scaling Up Focused HIV Prevention Programmes For Female Sex Workers in Nigeria

BackgroundThe HIV epidemic in Nigeria is complex with substantial heterogeneity in its distribution across different regions and diverse factors that drive the epidemic. Therefore, it is critical that HIV prevention...

Occupational Hazards and Coping Strategies of Sex Workers in Southwestern Nigeria

The researcher investigated occupational hazards of sex work and determined coping strategies adopted by female sex workers in Nigeria. Participants were 112 female sex workers selected from three urban towns in southwestern Nigeria. An instrument titled “Questionnaire on Sex Work” adapted from Akinnawo (1995) was administered to collect information on factors influencing the growth of the sex industry, occupational hazards in the industry, and coping mechanisms adopted by sex workers. It was found that the majority of sex workers joined the profession for socioeconomic reasons. Reported occupational hazards include poor health, risk of sexually transmitted diseases (STDs), police harassment, and loss of social prestige.

Sexual Risk Behaviors and HIV Among Female Sex Workers in Nigeria

Female sex workers (FSWs) account for about 20% of new HIV infections in Nigeria. We estimated the change in HIV prevalence and sexual risk behaviors between 2 consecutive rounds of integrated biological and behavioral surveillance surveys (IBBSSs) and determined correlates of HIV transmission among FSWs. In 2007 and 2010, HIV prevalence and risk behavior data on brothel-based (BB) and non-brothel-based (NBB) FSWs from the integrated biological and behavioral surveillance survey were evaluated in 6 Nigerian states. Logistic regression was used to identify correlates of HIV infection. A total of 2897 and 2963 FSWs were surveyed in 2007 and 2010, respectively. Overall HIV prevalence decreased in 2010 compared to 2007 (20% vs. 33%; P < 0.001), with similar magnitude of declines among BB-FSW (23% vs. 37%; P < 0.0001) and NBB-FSW (16% vs. 28%; P < 0.0001). Consistent condom use with boyfriends in the last 12 months was lower in 2010 compared to 2007 overall (23% vs. 25%; P = 0.02) and among BB-FSWs (17% vs. 23%; P < 0.01] while NBB-FSWs showed a marginal increase (30% vs. 27%; P = 0.08). FSWs residing in the Federal Capital Territory [adjusted odds ratio (AOR): 1.74 (1.34 - 2.27)] and Kano state [AOR: 2.07 (1.59 - 2.70)] were more likely to be HIV-positive while FSWs recruited in 2010 [AOR: 0.81 (0.77-0.85)] and those who had completed secondary education [AOR: 0.70 (0.60-0.80)] were less likely to be HIV-positive. Results suggest significant progress in reducing the burden of HIV among FSWs in Nigeria, although low condom use with boyfriends continued to be a potential bridge between FSWs and the general population. Venue-based prevention programs are needed to improve safer sex practices among BB-FSWs.

Estimates of human immunodeficiency virus incidence among female sex workers in north central Nigeria: implications for HIV clinical trials

We estimated the HIV incidence among commercial female sex workers (FSWs) in north central Nigeria using bimodal methodology. Using a cross-sectional study design, a total of 900 active FSWs between the ages of 18 and 35 years were recruited from 52 brothels within Nasarawa State, Nigeria. A rapid test algorithm was used to determine their HIV status. The BED IgG–Capture enzyme immunoassay (CEIA) was applied on the HIV-seropositive samples to detect recent HIV-1 infection for the estimation of incidence among those with HIV infection. Of the 900 FSWs tested, 335 (37.2%) were found to be positive for HIV. Of these, 63 showed evidence of recent infection. Using two third-generation BED analysis approaches that account for false-recent rate, an annualized adjusted HIV incidence of 11.97% (95% CI: 8.51–15.43%) and 12.36% (95% CI: 8.18–16.34%) was observed; difference P > 0.05. In addition, 875 (97.2%) of the FSWs readily agreed to participate in HIV clinical trials. We have developed the expertise and infrastructure necessary for clinical trial investigations in sub-Saharan Africa. We have recorded a high proportion of recent HIV infections among FSWs in Nigeria and also provided an enabling environment for future studies of HIV prevention methods.

HIV-related risk perception among female sex workers in Nigeria

BackgroundOver one-third of sex workers in Nigeria are infected with human immunodeficiency virus (HIV), yet there is a lack of understanding of sex workers’ own perception of sexual risk-taking. Applying the theory of cognitive dissonance, this paper examined the personal HIV risk perception of brothel-based sex workers.MethodsThe study is based on 24 focus group discussions held among brothel-based sex workers in four geographically and culturally dispersed cities in Nigeria.ResultsIt was found that sex workers underestimated their risk of infection and rationalized, defended, or justified their behaviors, a typical psychological response to worry, threat, and anxiety arising from the apparent discrepancies between beliefs and behaviors. To reduce dissonance, many sex workers had a strong belief in fatalism, predestination, and faith-based invulnerability to HIV infection. Many believed that one will not die of acquired immune deficiency syndrome if it is not ordained by God. The sex workers also had a high level of HIV-related stigma.ConclusionFrom these findings, most sex workers considered risk reduction and in particular condom use as far beyond their control or even unnecessary, as a result of their strong beliefs in fatalism and predestination. Therefore, one critical area of intervention is the need to assist sex workers to develop accurate means of assessing their personal vulnerability and self-appraisal of HIV-related risk.

Human Immunodeficiency Virus infection amongst female sex workers in Nigeria.

In most parts of the world, female sex workers (FSW) have been among the groups most vulnerable to and most affected by HIV. The data on HIV infection among FSW is very scanty in North central of Nigeria. OBJECTIVE To examine factors contributing to the spread of the HIV epidemic among FSW participating in a program for the prevention of transmission of HIV at the Jos University Teaching Hospital (JUTH) Jos, Plateau State Nigeria. METHODS: A total of 500 FSW were interviewed, but only 307 consented to give their blood samples to be tested for HIV and Syphilis and genital specimens were collected from them, analyzed for other sexually transmitted infections (STIs). Information about sociodemographic characteristics, sexual behaviors, knowledge about HIV and other STIs, HIV risk perception and history of STI-related symptoms were also documented. RESULT: The prevalence of HIV was 57.3% (176/307). HIV –1, HIV-1&2 and HIV-2 accounted for 96.0%, 2.3% and 1.7% respectively. Their mean age was 24.5 + 5.5years.The FSW within age groups 20-24 and 25-29 years were more affected with prevalence rates of 39.4% and 35.5%, respectively. In addition, those with genital symptoms and STIs during the last 12 months had increased risk of HIV by 68.6 (pValue

High prevalence of hepatitis B virus among female sex workers in Nigeria

Hepatitis B virus (HBV) infection is endemic in Nigeria and constitutes a public health menace. The prevalence of HBV infection in many professional groups has been described in Nigeria. However, literature on HBV infection among female sex workers (FSW) in Nigeria is scanty. FSW in Nigeria are not subjected to a preventive control of HBV infection. This study assesses the extent of spread of HBV among FSW in Nigeria. Seven hundred and twenty (n = 720) FSW (mean age = 26.7 years) were tested for hepatitis B surface antigen (HBsAg) by a double antibody sandwich ELISA method. The overall HBV prevalence among the FSW was 17.1%. FSWs between the ages of 31-35 year (20.5%) and those with 'age-at-first-sex' below 10 years of age (28%) were most affected. This high prevalence of a vaccine preventable disease is unacceptable, therefore, vaccination of this high risk HBV reservoir group should be considered worthwhile.