Mutagoma Mwumvaneza, Samuel Malamba S, Kayitesi Catherine, Gasasira Antoine R, Chitou Bassirou, Boer Kimberly, Hedt-Gauthier Bethany, Gupta Neil, Ntaganira Joseph, Nsanzimana Sabin
1 Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda.
2 U.S. Centers for Disease Control and Prevention (CDC), Center for Global Health (CGH), Division of Global HIV/AIDS (DGHA), Kigali, Rwanda.
Int J STD AIDS. 2017 Oct;28(11):1082-1089. doi: 10.1177/0956462416688137. Epub 2017 Jan 12.
Human immunodeficiency virus (HIV) prevalence is often high among female sex workers (FSWs) in sub-Saharan Africa. Understanding the dynamics of HIV infection in this key population is critical to developing appropriate prevention strategies. We aimed to describe the prevalence and associated risk factors among a sample of FSWs in Rwanda from a survey conducted in 2010. A cross-sectional biological and behavioral survey was conducted among FSWs in Rwanda. Time-location sampling was used for participant recruitment from 4 to 18 February 2010. HIV testing was done using HIV rapid diagnostic tests (RDT) as per Rwandan national guidelines at the time of the survey. Elisa tests were simultaneously done on all samples tested HIV-positive on RDT. Proportions were used for sample description; multivariable logistic regression model was performed to analyze factors associated with HIV infection. Of 1338 women included in the study, 1112 consented to HIV testing, and the overall HIV prevalence was 51.0%. Sixty percent had been engaged in sex work for less than five years and 80% were street based. In multivariable logistic regression, HIV prevalence was higher in FSWs 25 years or older (adjusted odds ratio [aOR] = 1.83, 95% [confidence interval (CI): 1.42-2.37]), FSWs with consistent condom use in the last 30 days (aOR = 1.39, [95% CI: 1.05-1.82]), and FSWs experiencing at least one STI symptom in the last 12 months (aOR = 1.74 [95% CI: 1.34-2.26]). There was an inverse relationship between HIV prevalence and comprehensive HIV knowledge (aOR = 0.65, [95% CI: 0.48-0.88]). HIV prevalence was high among a sample of FSWs in Rwanda, and successful prevention strategies should focus on HIV education, treatment of sexually transmitted infections, and proper and consistent condom use using an outreach approach.
在撒哈拉以南非洲地区，女性性工作者（FSW）中的人类免疫缺陷病毒（HIV）感染率通常较高。了解这一关键人群中HIV感染的动态情况对于制定适当的预防策略至关重要。我们旨在通过2010年开展的一项调查，描述卢旺达女性性工作者样本中的感染率及相关风险因素。在卢旺达的女性性工作者中进行了一项横断面生物学和行为调查。2010年2月4日至18日采用时间-地点抽样法招募参与者。根据卢旺达国家当时的指南，使用HIV快速诊断检测（RDT）进行HIV检测。对所有RDT检测呈HIV阳性的样本同时进行酶联免疫吸附测定（ELISA）检测。采用比例进行样本描述；运用多变量逻辑回归模型分析与HIV感染相关的因素。在纳入研究的1338名女性中，1112名同意进行HIV检测，总体HIV感染率为51.0%。60%从事性工作不到五年，80%为街头性工作者。在多变量逻辑回归分析中，25岁及以上的女性性工作者HIV感染率较高（调整优势比[aOR]=1.83，95%[置信区间（CI）：1.42 - 2.37]），过去30天内始终使用避孕套的女性性工作者（aOR = 1.39，[95% CI：1.05 - 1.82]），以及过去12个月内至少出现一种性传播感染症状的女性性工作者（aOR = 1.74 [95% CI：1.34 - 2.26]）。HIV感染率与全面的HIV知识之间呈负相关（aOR = 0.65，[95% CI：0.48 - 0.88]）。卢旺达女性性工作者样本中的HIV感染率较高，成功的预防策略应侧重于HIV教育、性传播感染的治疗以及采用外展方式正确且持续地使用避孕套。
