HIV Prevalence, Risk Factors for Infection, and Uptake of Prevention, Testing, and Treatment among Female Sex Workers in Namibia

Authors

Anna Jonas¹, Sadhna V. Patel^{2, 3,} , Frieda Katuta¹, Andrew D. Maher^{4, *,} , Karen M. Banda¹, Krysta Gerndt⁴, Ismelda Pietersen¹, Neia Menezes de Prata^{2, 3}, Nicholus Mutenda¹, Tuli Nakanyala^1, , Esme Kisting¹, Brown Kawana⁴, Ann-Marie Nietschke¹, Dimitri Prybylski^{2, 3}, Willi McFarland⁴, David W. Lowrance^{2, 3,}

¹Ministry of Health and Social Services, Windhoek, Namibia

²Division of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Windhoek, Namibia

³Division of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Atlanta, USA

⁴University of California San Francisco, Institute for Global Health Sciences, San Francisco, USA

^*Corresponding author. Email: Andrew.maher@ucsf.edu

DOI

10.2991/jegh.k.200603.001How to use a DOI?

Keywords

Sex workers; HIV prevalence; key populations; respondent-driven sampling; biobehavioral surveillance; Namibia

Abstract

Background: In most settings, Female Sex Workers (FSW) bear a disproportionate burden of Human Immunodeficiency Virus (HIV) disease worldwide. Representative data to inform the development of behavioral and biomedical interventions for FSW in Namibia have not been published.

Objectives: Our objectives were to measure HIV prevalence, identify risk factors for infection, and describe uptake of prevention, testing, and treatment among FSW in Namibia.

Methods: We conducted cross-sectional surveys using Respondent-driven Sampling (RDS) in the Namibian cities of Katima Mulilo, Oshikango, Swakopmund/Walvis Bay, and Windhoek. Participating FSW completed behavioral questionnaires and rapid HIV testing.

Results: City-specific ranges of key indicators were: HIV prevalence (31.0–52.3%), reached by prevention programs in the past 12 months (46.9–73.6%), condom use at last sex with commercial (82.1–91.1%) and non-commercial (87.0–94.2%) partners, and tested for HIV within past 12 months or already aware of HIV-positive serostatus (56.9–82.1%). Factors associated with HIV infection varied by site and included: older age, having multiple commercial or non-commercial sex partners, unemployment, being currently out of school, and lower education level. Among HIV-positive FSW, 57.1% were aware of their HIV-positive serostatus and 33.7% were on antiretroviral treatment.

Discussion: Our results indicate extremely high HIV prevalence and low levels of case identification and treatment among FSW in Namibia. Our results, which are the first representative community-based estimates among FSW in Namibia, can inform the scale-up of interventions to reduce the risk for HIV acquisition and onward transmission, including treatment as prevention and pre-exposure prophylaxis.

Copyright

© 2020 The Authors. Published by Atlantis Press International B.V.

Open Access

This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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TY  - JOUR
AU  - Anna Jonas
AU  - Sadhna V. Patel
AU  - Frieda Katuta
AU  - Andrew D. Maher
AU  - Karen M. Banda
AU  - Krysta Gerndt
AU  - Ismelda Pietersen
AU  - Neia Menezes de Prata
AU  - Nicholus Mutenda
AU  - Tuli Nakanyala
AU  - Esme Kisting
AU  - Brown Kawana
AU  - Ann-Marie Nietschke
AU  - Dimitri Prybylski
AU  - Willi McFarland
AU  - David W. Lowrance
PY  - 2020
DA  - 2020/06/19
TI  - HIV Prevalence, Risk Factors for Infection, and Uptake of Prevention, Testing, and Treatment among Female Sex Workers in Namibia
JO  - Journal of Epidemiology and Global Health
SP  - 351
EP  - 358
VL  - 10
IS  - 4
SN  - 2210-6014
UR  - https://doi.org/10.2991/jegh.k.200603.001
DO  - 10.2991/jegh.k.200603.001
ID  - Jonas2020
ER  -