Background Cervical cancer is the most common cancer in women in Sub-Saharan Africa. The situation is worst among female sex workers (FSW), a population with poor access to quality reproductive health services. This study aimed to: (1) estimate the prevalence of abnormal cervical screening test (ACST) and (2) assess the association between ACST and sexually transmitted infections (STIs)/lower genital tract infections (LGTIs) among FSW in Cotonou (Benin) and Bamako (Mali).

Methods We conducted a cross-sectional study among non-pregnant FSW aged 18 to 64 years from April 2017 to February 2018. We used a peer recruitment sampling strategy in two West African cities. Visual inspection with acetic acid (5%) and with Lugol’s iodine (VIA/VIL) were performed to screen for cervical cancer. Women were also screened for STIs/LGTIs, specifically those with Trichomonas vaginalis (TV), Candida albicans (CA), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and bacterial vaginosis (BV). ACST prevalence was computed and its association with STIs/LGTIs was assessed using multivariate logistic regression.

Results ACST prevalence was 20.2% among 312 FSW in Benin Vs. 10.5% among 353 FSW in Mali. Of these, 91.2% never had cervical screening. Mean age at sexual debut was 16.3 ± 3.0 years. The overall STIs/LGTIs prevalence rates were: TV, 2.7%; CT, 10.9%; NG, 19.4%; HIV, 23.0%; CA, 7.4% and BV, 37.1%. CA was the only infection associated with ACST (aOR = 4.03; 95%CI: 1.77–9.17). Also, there was a statistical association between a coinfection by CA-TV and ACST (aOR = 3.21; 95%CI: 1.47–7.01). Finally, age at sexual debut < 10 years old was significantly associated with ACST (aOR = 6.10; 95%CI: 1.19–31.21).

Conclusion The prevalence of ACST and STIs/LGTIs was very high; there is an obvious need to improve the diagnostic capability and the clinical management of these conditions among FSW of Sub-Saharan Africa.

Disclosure No significant relationships.