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Estimating the population size of female sex workers in Zimbabwe: comparison of estimates obtained using different methods in twenty sites and development of a national-level estimate

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Fearon, Elizabeth, Chabata, Sungai T, Magutshwa, Sitholubuhle, Ndori-Mharadze, Tendayi, Musemburi, Sithembile, Chidawanyika, Henry, Napierala, Sue, Gonese, Elizabeth, Herman Roloff, Amy, Tippett Barr, Beth A, Kilmarx, Peter H, Wong-Gruenwald, Ramona, Chidiya, Samson, Mhangara, Mutsa, Hanisch, Dagmar, Edwards, Jessie J, Rice, Brian, Taramusi, Isaac, Mbengeranwa, Tendai, Magure, Tapiwa, Manangazira, Portia, Mugurungi, Owen, Hargreaves, James R and Cowan, Frances ORCID: https://orcid.org/0000-0003-3087-4422 (2020) 'Estimating the population size of female sex workers in Zimbabwe: comparison of estimates obtained using different methods in twenty sites and development of a national-level estimate'. JAIDS: Journal of Acquired Immune Deficiency Syndromes, Vol 85, Issue 1, pp. 30-38.

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1. national_PSE_manuscript_revision_3Mar_clean.docx - Accepted Version
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2. Appendix1_Diagnostics_site_final_apr24 (1).pdf - Supplemental Material
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3. Appendix2_PSE_workshop_24april (1).pdf - Supplemental Material
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5. Table 3.docx - Supplemental Material
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4. Appendix3_PSE_workshop_slides_compiled_24apr.pdf - Supplemental Material
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Abstract

BACKGROUND:
National-level population size estimates (PSEs) for hidden populations are required for HIV programming and modelling. Various estimation methods are available at the site-level, but it remains unclear which are optimal and how best to obtain national-level estimates.

SETTING:
Zimbabwe METHODS:: Using 2015-2017 data from respondent-driven sampling surveys (RDS) among female sex workers (FSW) aged 18+ years, mappings, and programme records, we calculated PSEs for each of 20 sites across Zimbabwe, using up to three methods per site (service and unique object multipliers, census, and capture-recapture). We compared estimates from different methods, and calculated site medians. We estimated prevalence of sex work at each site using census data available on the number of 15-49 year-old women, generated a list of all 'hotspot' sites for sex work nationally, and matched sites into strata in which the prevalence of sex work from sites with PSEs was applied to those without. Directly and indirectly estimated PSEs for all hotspot sites were summed to provide a national-level PSE, incorporating an adjustment accounting for sex work outside hotspots.

RESULTS:
Median site PSEs ranged from 12,863 in Harare to 247 in a rural growth-point. Multiplier methods produced the highest PSEs. We identified 55 hotspots estimated to include 95% of all FSW. FSW nationally were estimated to number 40,491, 1.23% of women aged 15-49 years, (plausibility bounds 28,177-58,797, 0.86-1.79%, those under 18 considered sexually exploited minors).

CONCLUSION:
There are large numbers of FSW estimated in Zimbabwe. Uncertainty in population size estimation should be reflected in policy-making.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 300 General. Refugees
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
WA Public Health > Statistics. Surveys > WA 950 Theory or methods of medical statistics. Epidemiologic methods
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1097/QAI.0000000000002393
Depositing User: Tina Bowers
Date Deposited: 11 May 2020 13:03
Last Modified: 10 Aug 2020 11:14
URI: https://archive.lstmed.ac.uk/id/eprint/13999

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