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Changes over time in HIV prevalence and sexual behaviour among young female sex-workers in 14 sites in Zimbabwe, 2013-2016

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Chabata, Sungai Tafadzwa, Hensen, Bernadette, Chiyaka, Tarisai, Mushati, Phillis, Mtetwa, Sibongile, Hanisch, Dagmar, Napierala, Sue, Busza, Joanna, Floyd, Sian, Fearon, Elizabeth, Birdthistle, Isolde, Hargreaves, James R and Cowan, Frances ORCID: https://orcid.org/0000-0003-3087-4422 (2019) 'Changes over time in HIV prevalence and sexual behaviour among young female sex-workers in 14 sites in Zimbabwe, 2013-2016'. AIDS and Behavior. (In Press)

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Abstract

Background: Young female sex-workers (FSW) aged 18-24 are at high risk of HIV due to high numbers of sexual partners, difficulty negotiating condom use, increased risk of gender-based violence, and limited access to services. Here we describe changes in sexual behaviours among young FSW across Zimbabwe between 2013 and 2016, and risk factors for prevalent HIV in 2013 and 2016.

Methods: FSW ≥18 years were recruited using respondent-driven sampling in 14 sites across Zimbabwe in 2013 and 2016 as part of the SAPPH-IRe trial. We collected data on socio-demographics and sexual behaviour and offered HIV testing. Statistical analyses were RDS-II weighted. Characteristics of young FSW aged 18-24 were
described, stratified by age. Logistic regression was used to assess difference in sexual behaviours by reported HIV status between 2013 and 2016, and to explore associations with prevalent HIV in 2013 and 2016.

Results: 656 young FSW were recruited in 2013 and 503 in 2016. Characteristics of young FSW were similar across both surveys. HIV prevalence was si milar at both time points (35% vs 36%) and rose steeply with age. Condom-less sex with clients evidently
increased among women who reported being HIV negative (OR=1.69; 95%CI: 1.14- 2.51). After adjusting for age in 2016, young FSW who had ever been married had increased odds of testing HIV positive (OR=1.88; 95%CI: 1.04-3.39; P=0.036) compared with those who had never married. Young FSW who completed secondary
education or higher were less likely to test HIV positive (OR=0.41; 95%CI: 0.20-0.83; P=0.010) compared with those with primary education or less.

Conclusion: Young FSW remain at very high risk of HIV. Strategies to identify young FSW when they first start selling and refer them into services that address their economic, social and sexual vulnerabilities are critical.

Item Type: Article
Subjects: WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Sexually Transmitted Diseases > WC 140 Sexually transmitted diseases
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.41 General coverage
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1007/s10461-019-02410-1
Depositing User: Stacy Murtagh
Date Deposited: 25 Feb 2019 11:45
Last Modified: 11 Apr 2019 14:11
URI: http://archive.lstmed.ac.uk/id/eprint/10027

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