Objective To readjust HIV control programmes in Africa, we assessed the factors associated with high-risk behaviours and HIV infection among young female sex workers (FSW) in Burkina Faso.
Methods We carried out a cross-sectional study from September 2009 to September 2010 in Ouagadougou, the capital city. FSW were categorised as professionals and part-time sex workers (PTSW). After a face-to-face questionnaire, blood and urine samples were collected for HIV, HSV-2, genital infections and pregnancy. High-risk behaviour was defined as a recent unprotected sex with either casual clients, regular clients or regular partners.
Results We recruited 609 FSW including 188 (30.9%) professionals. Their median age was 21 years (IQR 19–23), and the prevalence of HIV was 10.3% among professionals and 6.5% among PTSW. Only 3 of 46 HIV-infected women were aware of their status. Overall, 277 (45.6%) women reported high-risk behaviours (41.2% among professionals and 47.5% among PTSW), which were driven mainly by non-systematic condom use with regular partners. In multivariable analysis, PTSW (adjusted OR (AOR)=1.89; 95% CI 1.27 to 2.82) and having a primary (AOR=1.75; 95% CI 1.15 to 2.67) or higher education level (AOR=1.80; 95% CI 1.13 to 2.89) remained associated with high-risk behaviours. HIV infection was associated with older age (AOR=1.44; 95% CI 1.22 to 1.71), with being married/cohabiting (AOR=2.70; 95% CI 1.21 to 6.04) and with Trichomonas vaginalis infection (AOR=9.63; 95% CI 2.93 to 31.59), while history of HIV testing was associated with a decreased risk (AOR=0.18; 95% CI 0.08 to 0.40).
Conclusions This study highlights the need for targeted interventions among young FSW focusing particularly on PTSW, sexual behaviours with regular partners and regular HIV testing.
- COMMERCIAL SEX
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Handling editor Jackie A Cassell
Contributors ITT contributed to designing the study, the acquisition, analysis and interpretation of the data. He also wrote the manuscript. NN contributed to designing the study, the acquisition, analysis and interpretation of the data. He also wrote with ITT the manuscript and supervised its development. NM, PVDP and PM contributed to designing the study, interpretation of the data and critically reviewed the manuscript. NMH, DO, FS, RS, AS and IK contributed to the acquisition of the data and critically reviewed the manuscript.
Funding The HIV prevaccine cohort was funded by the European and Developing Countries Clinical Trial Partnership (EDCTP) and by INSERM-ANRS (French National Agency for Research on AIDS and Viral Hepatitis).
Competing interests None declared.
Patient consent Obtained.
Ethics approval Research ethics committees of the Ministry of Health of Burkina Faso (approval number 2008-032) and the London School of Hygiene & Tropical Medicine (approval number 5476).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Results reported are related to the data collected at the screening visit. Behavioural, clinical and biological data collected during the follow-up of the cohort have been analysed to assess the impact of the intervention package on HIV, HSV-2 and pregnancy incidences. Please send an email to firstname.lastname@example.org if you need any data for further analysis.
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