RT Journal Article
SR Electronic
T1 HIV testing behaviour and HIV prevalence among female sex workers in Ukraine: findings from an Integrated Bio-Behavioural Survey, 2013–2014
JF Sexually Transmitted Infections
JO Sex Transm Infect
FD BMJ Publishing Group Ltd
SP 193
OP 200
DO 10.1136/sextrans-2018-053684
VO 95
IS 3
A1 Anna Tokar
A1 Iana Sazonova
A1 Sharmistha Mishra
A1 Pavlo Smyrnov
A1 Tetiana Saliuk
A1 Jeffrey V Lazarus
A1 Jacqueline E W Broerse
A1 Maria Roura
A1 James Blanchard
A1 Marissa L Becker
YR 2019
UL http://sti.bmj.com/content/95/3/193.abstract
AB Objectives Ukraine has one of the largest HIV epidemics in Europe, with high prevalence among female sex workers (FSWs). We aimed to identify factors associated with HIV testing and receipt of the test result in the last 12 months, HIV prevalence and self-reported positive status among FSWs in Ukraine.Methods We used data from an Integrated Bio-Behavioural Survey among FSWs conducted in 2013–2014. The survey methodology combined three sampling strategies: time and location sampling, respondent-driven sampling and key informant recruitment. We used multivariable regression to identify factors associated with self-reported HIV testing in the last 12 months, HIV prevalence and self-reported positive status among FSWs living with HIV. Explored factors included: age, age at first sex, age at entry into sex work, education, marital status, employment status beside sex work, condom use with last paying or non-paying sexual partner, drug or alcohol consumption and sex work venue.Results Recent HIV testing was low overall with only 63.2% of FSWs reported having tested and received their test result in the last 12 months prior to the survey. HIV prevalence was 7.1% overall, but only 45.0% of FSWs living with HIV were aware of their HIV status. Testing in the last 12 months with receipt of test result was less common among FSWs who used drugs ever in life (adjusted OR (AOR) 0.7, 95% CI 0.6 to 0.9), women soliciting clients indoors (AOR 0.8, 95% CI 0.7 to 0.9) and those not using a condom with last paying sexual partner (AOR 0.3, 95% CI 0.2 to 0.5). HIV positivity was associated with history of ever using drugs (AOR 2.3, 95% CI 1.4 to 3.6) and soliciting clients outdoors (AOR 1.5, 95% CI 1.1 to 2.0). Women working indoors were less aware of their positive status (AOR 0.1, 95% CI 0.1 to 0.9).Conclusion HIV prevalence is high among FSWs in Ukraine, and testing and knowledge of one’s status remain insufficient. HIV testing programmes need to expand with strategies to reach specific subgroups of FSWs.