Centre for Global Public Health, University of Manitoba, Rady Faculty of Health Sciences, Winnipeg, Manitoba, Canada
National AIDS Control Programme, Islamabad, Pakistan.
Sex Transm Infect. 2021 Sep;97(6):446-451. doi: 10.1136/sextrans-2020-054526. Epub 2020 Oct 20.
We examined data collected as part of the fifth round of integrated biological and behavioural surveillance to determine the prevalence and factors associated with HIV infection among female sex workers (FSWs) in Pakistan.
FSWs were defined as 'all females, age 13 years and above, who receive money or goods in exchange for sexual services, regardless of the site of operation'. Data were collected between October 2016 and January 2017 in 18 cities using multistage sampling techniques to randomly select FSWs from spots facilitated by peers. Behavioural data were collected by interviewers using structured questionnaires, which was followed by obtaining finger prick blood samples tested for HIV using two rapid tests. Multivariate logistic regression analysis was done to assess independent associations of potential correlates using HIV status as dependent variable.
We invited 5728 FSWs to participate, of which 68 refused to participate (refusal rate=1.2%). Of the 5660 FSWs who participated, 121 were HIV seropositive (weighted HIV prevalence 2.3%; 95% CI 1.9% to 2.7%) mostly concentrated within cities in Sindh. Multivariate analysis showed being uneducated/illiterate (adjusted OR (aOR) 2.1; 95% CI 1.4 to 3.4), directly dealing with clients without a pimp (aOR 1.8; 95% CI 1.1 to 2.8), non-use of condom with clients (aOR 1.8; 95% CI 1.1 to 2.8), having sexual contact with people who inject drugs (PWID) (aOR 2.2; 95% CI 1.3 to 3.7) and non-participation in HIV programmes (aOR 1.7; 95% CI 1.0 to 3.1) as factors independently associated with HIV seropositivity.
We found a weighted national HIV prevalence of 2.3% and identified factors independently associated with HIV in FSWs. The country needs to scale up HIV prevention programmes to improve coverage, prioritising FSWs who are illiterate, work independently and have PWID as sex partners. Emphasis should be laid on strategies to improve condom use with both regular and non-regular partners.
我们检查了作为第五轮综合生物和行为监测的一部分收集的数据，以确定巴基斯坦性工作者（FSW）中艾滋病毒感染的流行率和相关因素。
FSW 被定义为“所有年龄在 13 岁及以上的女性，她们以性服务换取金钱或物品，无论其工作地点如何”。数据是在 2016 年 10 月至 2017 年 1 月期间在 18 个城市使用多阶段抽样技术收集的，从同行协助的地点随机选择 FSW。行为数据由访谈者使用结构化问卷收集，随后采集指尖采血样，使用两种快速检测进行艾滋病毒检测。使用多变量逻辑回归分析评估使用 HIV 状况作为因变量的潜在相关性的独立关联。
我们邀请了 5728 名 FSW 参加，其中 68 人拒绝参加（拒绝率为 1.2%）。在 5660 名参加的 FSW 中，有 121 人艾滋病毒血清阳性（加权 HIV 流行率为 2.3%；95%CI 1.9%至 2.7%），主要集中在信德省的城市。多变量分析显示，未受教育/文盲（调整后的比值比（aOR）2.1；95%CI 1.4 至 3.4）、直接与客户没有皮条客（aOR 1.8；95%CI 1.1 至 2.8）、与客户不使用安全套（aOR 1.8；95%CI 1.1 至 2.8）、与注射毒品者（PWID）发生性接触（aOR 2.2；95%CI 1.3 至 3.7）和不参加艾滋病毒方案（aOR 1.7；95%CI 1.0 至 3.1）是与 HIV 血清阳性相关的独立因素。
我们发现全国加权 HIV 流行率为 2.3%，并确定了与 FSW 中 HIV 相关的独立因素。该国需要扩大艾滋病毒预防方案，以提高覆盖面，优先考虑文盲、独立工作且与 PWID 发生性接触的 FSW。应重点制定策略，提高与常规和非常规伴侣使用安全套的比例。
