Sexual risk behaviors and HIV among female sex workers in Nigeria.

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.