Bitty-Anderson Alexandra M, Gbeasor-Komlanvi Fifonsi A, Tchankoni Martin Kouame, Sadio Arnold, Salou Mounerou, Coffie Patrick A, Dagnra Claver A, Ekouevi Didier K
Centre Africain de Recherches en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo.
INSERM U1219, Bordeaux Population Health Research, ISPED, Université de Bordeaux, Bordeaux, France.
Arch Public Health. 2022 Mar 24;80(1):92. doi: 10.1186/s13690-022-00851-0.
The HIV epidemic remains an important public health challenge for the sub-Saharan region. Female Sex Workers (FSW) in this region are among the most vulnerable of the key population groups with HIV prevalence as high as twice that of the general population. The aim of this study was to estimate HIV prevalence and explore sexual risk behaviors among FSW in Togo.
A cross-sectional study using a Respondent Driven Sampling method was conducted across the six regions of country among FSW in 2017. A comprehensive questionnaire was used to explore socio-demographic characteristics, sexual history, HIV knowledge, and sexual behaviors. HIV rapid tests were used to assess HIV infection.
A total of 1,036 FSW, with a median age of 26 years old [interquartile range (IQR): 22-33], participated in the study, with 49.2% (n = 510) of them having reached secondary school. Median age at first sexual intercourse was 20 years old [IQR: 17-25] and estimated number of clients per week was of 5 [IQR: 3-10]. A total of 936 (95.6%) reported the use of a condom during last sexual intercourse with a client and 493 (47.6%) reported the use of a condom during their last sexual intercourse with a partner or husband. HIV prevalence was 13.2% [95% CI: 11.2 - 15.4], and was associated with age (being between 26 and 32 years old; aOR = 4.5; 95% CI: [2.4 - 9.1], p < 0.0001) and ≥ 33 years old; aOR = 6.4; 95% CI [3.5 - 12.7], p < 0.0001), education level (being in primary school or less; aOR = 1.7; 95% CI: [1.1-2.6]; p = 0.012) and the number of partners per week (more than 2 and 3 partners; aOR = 2.5; 95% CI [1.2-5.2]; p = 0.014).
HIV prevalence and sexual risk behaviors remain high among FSW in Togo, despite prevention efforts aimed at curbing this trend. Other factors, such as access and availability of condoms, the social and legal environment in which FSW operate, should be considered for HIV prevention strategies in this population.
艾滋病毒流行仍然是撒哈拉以南地区面临的一项重大公共卫生挑战。该地区的女性性工作者是最易感染艾滋病毒的关键人群之一，其艾滋病毒感染率高达普通人群的两倍。本研究的目的是估计多哥女性性工作者中的艾滋病毒感染率，并探讨她们的性风险行为。
2017年，在该国六个地区对女性性工作者开展了一项采用应答驱动抽样方法的横断面研究。使用一份综合问卷来探究社会人口学特征、性史、艾滋病毒知识和性行为。采用艾滋病毒快速检测来评估艾滋病毒感染情况。
共有1036名女性性工作者参与了该研究，她们的年龄中位数为26岁[四分位间距（IQR）：22 - 33岁]，其中49.2%（n = 510）接受过中学教育。首次性行为的年龄中位数为20岁[IQR：17 - 25岁]，每周估计的嫖客数量为5人[IQR：3 - 10人]。共有936人（95.6%）报告在与嫖客的最后一次性交中使用了避孕套，493人（47.6%）报告在与伴侣或丈夫的最后一次性交中使用了避孕套。艾滋病毒感染率为13.2%[95%置信区间：11.2 - 15.4]，并且与年龄（26至32岁之间；调整后比值比（aOR）= 4.5；95%置信区间：[2.4 - 9.1]，p < 0.0001）以及≥33岁（aOR = 6.4；95%置信区间[3.5 - 12.7]，p < 0.0001）、教育水平（小学及以下学历；aOR = 1.7；95%置信区间：[1.1 - 2.6]；p = 0.012）和每周性伴侣数量（超过2个和3个伴侣；aOR = 2.5；95%置信区间[1.2 - 5.2]；p = 0.014）有关。
尽管有旨在遏制这一趋势的预防措施，但多哥女性性工作者中的艾滋病毒感染率和性风险行为仍然很高。在针对这一人群的艾滋病毒预防策略中，应考虑其他因素，如避孕套的获取和供应情况，女性性工作者所处的社会和法律环境。
