Skip to main content

Advertisement

SpringerLink
Log in

Socio-Demographic Characteristics and Behavioral Risk Factors of Female Sex Workers in Sub-Saharan Africa: A Systematic Review

  • Substantive Review
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Sex work remains an important contributor to HIV transmission within early, advanced and regressing epidemics in sub-Saharan Africa, but its social and behavioral underpinnings remain poorly understood, limiting the impact of HIV prevention initiatives. This article systematically reviews the socio-demographics of female sex workers (FSW) in this region, their occupational contexts and key behavioral risk factors for HIV. In total 128 relevant articles were reviewed following a search of Medline, Web of Science and Anthropological Index. FSW commonly have limited economic options, many dependents, marital disruption, and low education. Their vulnerability to HIV, heightened among young women, is inextricably linked to the occupational contexts of their work, characterized most commonly by poverty, endemic violence, criminalization, high mobility and hazardous alcohol use. These, in turn, predict behaviors such as low condom use, anal sex and co-infection with other sexually transmitted infections. Sex work in Africa cannot be viewed in isolation from other HIV-risk behaviors such as multiple concurrent partnerships—there is often much overlap between sexual networks. High turn-over of FSW, with sex work duration typically around 3 years, further heightens risk of HIV acquisition and transmission. Targeted services at sufficiently high coverage, taking into account the behavioral and social vulnerabilities described here, are urgently required to address the disproportionate burden of HIV carried by FSW on the continent.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Godin G, Tinka Bah A, Sow A, Minani I, Morin D, Alary M. Correlates of condom use among sex workers and their boyfriends in three West African countries. AIDS Behav. 2008;12(3):441–51.

    Article  PubMed  Google Scholar 

  2. Ray S, van De Wijgert J, Mason P, Ndowa F, Maposhere C. Constraints faced by sex workers in use of female and male condoms for safer sex in urban Zimbabwe. J Urban Health. 2001;78(4):581–92.

    PubMed  CAS  Google Scholar 

  3. Morison L, Weiss HA, Buve A, et al. Commercial sex and the spread of HIV in four cities in sub-Saharan Africa. AIDS. 2001;15(Suppl 4):S61–9.

    Article  PubMed  Google Scholar 

  4. Aklilu M, Messele T, Tsegaye A, et al. Factors associated with HIV-1 infection among sex workers of Addis Ababa, Ethiopia. AIDS. 2001;15(1):87–96.

    Article  PubMed  CAS  Google Scholar 

  5. Chen L, Jha P, Stirling B, et al. Sexual risk factors for HIV infection in early and advanced HIV epidemics in sub-Saharan Africa: systematic overview of 68 epidemiological studies. PLoS ONE. 2007;2(10):e1001.

    Article  PubMed  Google Scholar 

  6. Vandepitte J, Lyerla R, Dallabetta G, Crabbe F, Alary M, Buve A. Estimates of the number of female sex workers in different regions of the world. Sex Transm Infect. 2006;82(Suppl 3:iii):18–25.

    Google Scholar 

  7. Talbott JR. Size matters: the number of prostitutes and the global HIV/AIDS pandemic. PLoS One. 2007;2(6):1–8.

    Article  Google Scholar 

  8. Cwikel JG, Lazer T, Press F, Lazer S. Sexually transmissible infections among female sex workers: an international review with an emphasis on hard-to-access populations. Sex Health. 2008;5:9–16.

    Article  PubMed  Google Scholar 

  9. Steen R, Dallabetta G. Sexually transmitted infection control with sex workers: regular screening and presumptive treatment augment efforts to reduce risk and vulnerability. Reprod Health Matters. 2003;11(22):74–90.

    Article  PubMed  Google Scholar 

  10. Shahmanesh M, Patel V, Mabey D, Cowan F. Effectiveness of interventions for the prevention of HIV and other sexually transmitted infections in female sex workers in resource poor setting: a systematic review. Trop Med Int Health. 2008;13(5):659–79.

    Article  PubMed  Google Scholar 

  11. Rekart ML. Sex-work harm reduction. Lancet. 2005;366(9503):2123–34.

    Article  PubMed  Google Scholar 

  12. Parker R, Easton D, Klein CH. Structural barriers and facilitators in HIV prevention: a review of international research. AIDS. 2000;14(suppl. 1):S22–32.

    Article  PubMed  Google Scholar 

  13. Aggleton P. Sexuality, HIV prevention, vulnerability and risk. J Psychol Human Sex. 2004;16(1):1–11.

    Article  Google Scholar 

  14. WHO. Toolkit for targeted HIV/AIDS prevention and care in sex work settings. http://www.who.int/hiv/topics/vct/sw_toolkit/context/en/index3.html; 2005. Report No.: ISBN92415966.

  15. Merten S, Haller T. Culture, changing livelihoods, and HIV/AIDS discourse: reframing the institutionalization of fish-for-sex exchange in the Zambian Kafue flats. Cult Health Sex. 2007;9(1):69–83.

    Article  PubMed  Google Scholar 

  16. Hunter M. The materiality of everyday sex: thinking beyond ‘prostitution’. Afr Stud. 2002;61(1):99–120.

    Article  Google Scholar 

  17. Dunkle KL, Jewkes RK, Brown HC, Gray GE, McIntryre JA, Harlow SD. Transactional sex among women in Soweto, South Africa: prevalence, risk factors and association with HIV infection. Soc Sci Med. 2004;59(8):1581–92.

    Article  PubMed  Google Scholar 

  18. Miller CL, Bangsberg DR, Tuller DM, et al. Food insecurity and sexual risk in an HIV endemic community in Uganda. AIDS Behav 2010; Apr 20.

  19. Wojcicki JM. “She drank his money”: survival sex and the problem of violence in taverns in Gauteng province, South Africa. Med Anthropol Q. 2002;16(3):267–93.

    Article  PubMed  Google Scholar 

  20. Kaufman CE, Stavrou SE. Bus fare please: the economics of sex and gifts among young people in South Africa. Cult Health Sex. 2004;6(5):377–91.

    Article  Google Scholar 

  21. UNAIDS. Regional UNAIDS workshop on sex work in West and Central Africa. Abidjan, Cote d’Ivoire, 21–24 March 2000; 2000.

  22. Oyefara JL. Food insecurity, HIV/AIDS pandemic and sexual behaviour of female commercial sex workers in Lagos metropolis, Nigeria. SAHARA J. 2007;4(2):626–35.

    PubMed  CAS  Google Scholar 

  23. Laurent C, Seck K, Coumba N, et al. Prevalence of HIV and other sexually transmitted infections, and risk behaviours in unregistered sex workers in Dakar, Senegal. AIDS. 2003;17(12):1811–6.

    Article  PubMed  Google Scholar 

  24. Elmore-Meegan M, Conroy RM, Agala CB. Sex workers in Kenya, numbers of clients and associated risks: an exploratory survey. Reprod Health Matters. 2004;12(23):50–7.

    Article  PubMed  Google Scholar 

  25. Pepin J, Labbe AC, Khonde N, et al. Mycoplasma genitalium: an organism commonly associated with cervicitis among west African sex workers. Sex Transm Infect. 2005;81(1):67–72.

    Article  PubMed  CAS  Google Scholar 

  26. Oladosu M, Ladipo O. Consistent condom use among sex workers in Nigeria. PSI Research Division, Working Paper No. 39. Population Services International; 2001.

  27. Gomes do Espirito Santo ME, Etheredge GD. And then I became a prostitute. Some aspects of prostitution and brothel prostitutes in Dakar, Senegal. Soc Sci J. 2004;41(1):137–46.

    Article  Google Scholar 

  28. Asamoah-Adu C, Khonde N, Avorkliah M, et al. HIV infection among sex workers in Accra: need to target new recruits entering the trade. J Acquir Immune Defic Syndr. 2001;28(4):358–66.

    PubMed  CAS  Google Scholar 

  29. Sobela F, Pepin J, Gbeleou S, et al. A tale of two countries: HIV among core groups in Togo. J Acquir Immune Defic Syndr. 2009;51(2):216–23.

    Article  PubMed  Google Scholar 

  30. Kayembe PK, Mapatano MA, Busangu AF, et al. Determinants of consistent condom use among female commercial sex workers in the Democratic Republic of Congo: implications for interventions. Sex Transm Infect. 2008;84(3):202–6.

    Article  PubMed  CAS  Google Scholar 

  31. Hubbard D, Zimba E. Sex work and the law in Namibia: a culture sensitive approach. Res Sex Work. 2003;6:10–1.

    Google Scholar 

  32. Campbell C. Selling sex in the time of AIDS: the psycho-social context of condom use by sex workers on a Southern African mine. Soc Sci Med. 2000;50(4):479–94.

    Article  PubMed  CAS  Google Scholar 

  33. Agha S, Nchima MC. Life-circumstances, working conditions and HIV risk among street and nightclub-based sex workers in Lusaka, Zambia. Cult Health Sex. 2004;6(4):283–99.

    Article  PubMed  Google Scholar 

  34. Pauw I, Brener L. ‘You are just whores—you can’t be raped’: barriers to safe sex practices among women street workers in Cape Town. Cult Health Sex. 2003;5(6):465–81.

    Article  Google Scholar 

  35. Gysels M, Pool R, Nnalusiba B. Women who sell sex in a Ugandan trading town: life histories, survival strategies and risk. Soc Sci Med. 2002;54(2):179–92.

    Article  PubMed  Google Scholar 

  36. Stadler J, Delany S. The ‘healthy brothel’: the context of clinical services for sex workers in Hillbrow, South Africa. Cult Health Sex. 2006;8(5):451–64.

    Article  PubMed  Google Scholar 

  37. Gysels M, Pool R, Bwanika K. Truck drivers, middlemen and commercial sex workers: AIDS and the mediation of sex in south west Uganda. AIDS Care. 2001;13(3):373–85.

    Article  PubMed  CAS  Google Scholar 

  38. Vuylsteke BL, Ghys PD, Traore M, et al. HIV prevalence and risk behavior among clients of female sex workers in Abidjan, Cote d’Ivoire. AIDS. 2003;17(11):1691–4.

    Article  PubMed  Google Scholar 

  39. Trotter H. Soliciting sailors: the temporal dynamic of dockside prostitution in Durban and Cape Town. J South Afr Stud. 2009;35(3):699–713.

    Article  Google Scholar 

  40. Ferguson AG, Morris CN. Mapping transactional sex on the Northern Corridor highway in Kenya. Health Place. 2007;13(2):504–19.

    Article  PubMed  Google Scholar 

  41. Meekers D. Going underground and going after women: trends in sexual risk behaviour among gold miners in South Africa. Int J STD AIDS. 2000;11(1):21–6.

    Article  PubMed  CAS  Google Scholar 

  42. Deceuninck G, Asamoah-Adu C, Khonde N, et al. Improvement of clinical algorithms for the diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis by the use of Gram-stained smears among female sex workers in Accra, Ghana. Sex Transm Dis. 2000;27(7):401–10.

    Article  PubMed  CAS  Google Scholar 

  43. Luchters S, Chersich MF, Rinyiru A, et al. Impact of five years of peer-mediated interventions on sexual behavior and sexually transmitted infections among female sex workers in Mombasa, Kenya. BMC Public Health. 2008;8:143.

    Article  PubMed  Google Scholar 

  44. Vandepitte JM, Malele F, Kivuvu DM, et al. HIV and other sexually transmitted infections among female sex workers in Kinshasa, Democratic Republic of Congo, in 2002. Sex Transm Dis. 2007;34(4):203–8.

    Article  PubMed  Google Scholar 

  45. Kruse N, Behets FM, Vaovola G, et al. Participatory mapping of sex trade and enumeration of sex workers using capture-recapture methodology in Diego-Suarez, Madagascar. Sex Transm Dis. 2003;30(8):664–70.

    Article  PubMed  Google Scholar 

  46. Morris CN, Ferguson AG. Estimation of the sexual transmission of HIV in Kenya and Uganda on the trans-Africa highway: the continuing role for prevention in high risk groups. Sex Transm Infect. 2006;82(5):368–71.

    Article  PubMed  CAS  Google Scholar 

  47. Vuylsteke B, Vandenhoudt H, Langat L, et al. Capture recapture for estimating the size of the female sex worker population in three cities in Cote d’Ivoire and in Kisumu, western Kenya. Trop Med Int Health. 2010;15(12):1537–43.

    Article  PubMed  Google Scholar 

  48. Agha S, Nchima MC. Life-circumstances, working conditions and HIV risk among street and nightclub-based sex workers in Lusaka, Zambia. Cult Health Sex. 2004;6(4):283–99.

    Article  PubMed  Google Scholar 

  49. Nagot N, Ouedraogo A, Ouangre A, et al. Is sexually transmitted infection management among sex workers still able to mitigate the spread of HIV infection in West Africa? J Acquir Immune Defic Syndr. 2005;39(4):454–8.

    Article  PubMed  Google Scholar 

  50. Izugbara CO. ‘Ashawo suppose shine her eyes’: female sex workers and sex work risks in Nigeria. Health Risk Soc. 2005;7(2):141–59.

    Article  Google Scholar 

  51. Richter ML, Chersich MF, Scorgie F, Luchters S, Temmerman M, Steen R. Sex work and the 2010 FIFA World Cup: time for public health imperatives to prevail. Glob Health. 2010;6(1):1.

    Article  Google Scholar 

  52. Arnott J, Crago AL. Rights not rescue: a report on female, male, and trans sex workers’ human rights in Botswana, Namibia, and South Africa. New York: Open Society Institute; 2009.

    Google Scholar 

  53. Gould C. Selling sex in Cape Town: sex work and human trafficking in a South African City. Pretoria: Institute for Security Studies; 2008.

    Google Scholar 

  54. Wojcicki JM, Malala J. Condom use, power and HIV/AIDS risk: sex-workers bargain for survival in Hillbrow/Joubert Park/Berea, Johannesburg. Soc Sci Med. 2001;53(1):99–121.

    Article  PubMed  CAS  Google Scholar 

  55. WHO. Violence against women and HIV/AIDS: critical intersections. Violence against sex workers and HIV prevention. 2005 [cited 12 December 2009]. Available from: www.who.int/gender.

  56. Pettifor A, Beksinska ME, Rees H. High knowledge and high risk behaviour: a profile of hotel-based sex workers in inner-city Johannesburg. Afr J Reprod Health. 2000;4(2):35–43.

    Article  Google Scholar 

  57. Campbell C. ‘Letting them die’: why HIV/AIDS interventions fail. Cape Town: Double Story Books; 2003.

    Google Scholar 

  58. Homaifar N, Wasik SZ. Interviews with senegalese commercial sex trade workers and implications for social programming. Health Care Women Int. 2005;26(2):118–33.

    Article  PubMed  Google Scholar 

  59. Voeten HA, Egesah OB, Varkevisser CM, Habbema JD. Female sex workers and unsafe sex in urban and rural Nyanza, Kenya: regular partners may contribute more to HIV transmission than clients. Trop Med Int Health. 2007;12(2):174–82.

    PubMed  CAS  Google Scholar 

  60. Tekola B. Negotiating social space: sex-workers and the social context of sex work in Addis Ababa. African study monographs; 2005;29(supplement):169–83.

  61. PSI Angola. HIV/AIDS TRaC study evaluating condom use among commercial sex workers in Cunene Province. Washington: Population Services International; 2007.

  62. Wang C, Hawes SE, Gaye A, et al. HIV prevalence, previous HIV testing, and condom use with clients and regular partners among Senegalese commercial sex workers. Sex Transm Infect. 2007;83:534–40.

    Article  PubMed  CAS  Google Scholar 

  63. Kane CT, Diawara S, Ndiaye HD, et al. Concentrated and linked epidemics of both HSV-2 and HIV-1/HIV-2 infections in Senegal: public health impacts of the spread of HIV. Int J STD AIDS. 2009;20(11):793–6.

    Article  PubMed  Google Scholar 

  64. Schwandt M, Morris C, Ferguson A, Ngugi E, Moses S. Anal and dry sex in commercial sex work, and relation to risk for sexually transmitted infections and HIV in Meru, Kenya. Sex Transm Infect. 2006;82(5):392–6.

    Article  PubMed  CAS  Google Scholar 

  65. Odek WO, Busza J, Morris CN, Cleland J, Ngugi EN, Ferguson AG. Effects of micro-enterprise services on HIV risk behaviour among female sex workers in Kenya’s urban slums. AIDS Behav. 2009;13(3):449–61.

    Article  PubMed  Google Scholar 

  66. Ntumbanzondo M, Dubrow R, Niccolai LM, Mwandagalirwa K, Merson MH. Unprotected intercourse for extra money among commercial sex workers in Kinshasa, Democratic Republic of Congo. AIDS Care. 2006;18(7):777–85.

    Article  PubMed  CAS  Google Scholar 

  67. Alemu H, Mariam DH, Belay KA, Davey G. Factors predisposing out-of-school youths to HIV/AIDS-related risky sexual behaviour in northwest Ethiopia. J Health Popul Nutr. 2007;25(3):344–50.

    PubMed  Google Scholar 

  68. Fonck K, Kaul R, Keli F, et al. Sexually transmitted infections and vaginal douching in a population of female sex workers in Nairobi, Kenya. Sex Transm Infect. 2001;77(4):271–5.

    Article  PubMed  CAS  Google Scholar 

  69. Sopheab H, Morineau G, Neal JJ, Saphonn V, Fylkesnes K. Sustained high prevalence of sexually transmitted infections among female sex workers in Cambodia: high turnover seriously challenges the 100% condom use programme. BMC Infect Dis. 2008;8:167.

    Article  PubMed  Google Scholar 

  70. Pettifor AE, Turner AN, Van Damme K, et al. Increased risk of chlamydial and gonococcal infection in adolescent sex workers in Madagascar. Sex Transm Dis. 2007;34(7):475–8.

    PubMed  Google Scholar 

  71. Nguyen VT, Nguyen TL, Nguyen DH, et al. Sexually transmitted infections in female sex workers in five border provinces of Vietnam. Sex Transm Dis. 2005;32(9):550–6.

    Article  PubMed  Google Scholar 

  72. Chersich M, Rees HV. Vulnerability of women in southern Africa to infection with HIV: biological determinants and priority health sector interventions. AIDS. 2008;22(suppl 4):S1–14.

    Article  Google Scholar 

  73. Khan MR, Patnaik P, Brown L, Nagot N, Salouka S, Weir S. Mobility and HIV-related sexual behavior in Burkina Faso. AIDS Behav. 2008;12:202–12.

    Article  PubMed  Google Scholar 

  74. Gilgen D, Williams BG, MacPhail C, et al. The natural history of HIV/AIDS in a major goldmining centre in South Africa: results of a biomedical and social survey. South Afr J Sci. 2001;97(9–10):387–92.

    Google Scholar 

  75. Ghys PD, Diallo MO, Ettiegne-Traore V, et al. Increase in condom use and decline in HIV and sexually transmitted diseases among female sex workers in Abidjan, Cote d’Ivoire, 1991–1998. AIDS. 2002;16(2):251–8.

    Article  PubMed  Google Scholar 

  76. Nagot N, Ouangre A, Ouedraogo A, et al. Spectrum of commercial sex activity in Burkina Faso: classification model and risk of exposure to HIV. J Acquir Immune Defic Syndr. 2002;29(5):517–21.

    PubMed  Google Scholar 

  77. Laurent C, Henzel D, Mulanga-Kabeya C, Maertens G, Larouze B, Delaporte E. Seroepidemiological survey of hepatitis C virus among commercial sex workers and pregnant women in Kinshasa, Democratic Republic of Congo. Int J Epidemiol. 2001;30(4):872–7.

    Article  PubMed  CAS  Google Scholar 

  78. Alary M, Mukenge-Tshibaka L, Bernier F, et al. Decline in the prevalence of HIV and sexually transmitted diseases among female sex workers in Cotonou, Benin, 1993–1999. AIDS. 2002;16(3):463–70.

    Article  PubMed  Google Scholar 

  79. Kudrati M, Plummer ML, Yousif ND. Children of the sug: a study of the daily lives of street children in Khartoum, Sudan, with intervention recommendations. Child Abuse Negl. 2008;32(4):439–48.

    Article  PubMed  Google Scholar 

  80. Wutoh AK, Kumoji EK, Xue Z, Campusano G, Wutoh RD, Ofosu JR. HIV knowledge and sexual risk behaviors of street children in Takoradi, Ghana. AIDS Behav. 2006;10(2):209–15.

    Article  PubMed  Google Scholar 

  81. Owoaje ET, Uchendu OC. Sexual risk behaviour of street youths in south west Nigeria. East Afr J Public Health. 2009;6(3):274–9.

    PubMed  CAS  Google Scholar 

  82. Riedner G, Rusizoka M, Hoffmann O, et al. Baseline survey of sexually transmitted infections in a cohort of female bar workers in Mbeya Region, Tanzania. Sex Transm Infect. 2003;79(5):382–7.

    Article  PubMed  CAS  Google Scholar 

  83. Okonofua FE, Ogbomwan SM, Alutu AN, Kufre O, Eghosa A. Knowledge, attitudes and experiences of sex trafficking by young women in Benin City, South–South Nigeria. Soc Sci Med. 2004;59(6):1315–27.

    Article  PubMed  CAS  Google Scholar 

  84. McCarthy K, Chersich MF, Vearey J, et al. Good treatment outcomes among foreigners receiving antiretroviral therapy in Johannesburg, South Africa. Int J STD AIDS. 2009;20(12):858–62.

    Article  PubMed  CAS  Google Scholar 

  85. Van Blerk L. AIDS, mobility and commercial sex in Ethiopia: implications for policy. AIDS Care. 2007;19(1):79–86.

    Article  PubMed  Google Scholar 

  86. Steen R, Ralepeli S, DeCoito T. Lesedi: services for women at high risk help reduce sexually transmitted infection (STI) prevalence in a South African mining community. FHI/UNAIDS best practices in HIV/AIDS prevention collection. Arlington: FHI/UNAIDS; 2001.

    Google Scholar 

  87. Clift S, Anemona A, Watson-Jones D, et al. Variations of HIV and STI prevalences within communities neighbouring new goldmines in Tanzania: importance for intervention design. Sex Transm Infect. 2003;79(4):307–12.

    Article  PubMed  CAS  Google Scholar 

  88. Steen R, Vuylsteke B, DeCoito T, et al. Evidence of declining STD prevalence in a South African mining community following a core-group intervention. Sex Transm Dis. 2000;27(1):1–8.

    Article  PubMed  CAS  Google Scholar 

  89. Ghys PD, Diallo MO, Ettiegne-Traore V, et al. Effect of interventions to control sexually transmitted disease on the incidence of HIV infection in female sex workers. Aids. 2001;15(11):1421–31.

    Article  PubMed  CAS  Google Scholar 

  90. Mukenge-Tshibaka L, Alary M, Lowndes CM, et al. Syndromic versus laboratory-based diagnosis of cervical infections among female sex workers in Benin: implications of nonattendance for return visits. Sex Transm Dis. 2002;29(6):324–30.

    Article  PubMed  Google Scholar 

  91. Vickerman P, Terris-Prestholt F, Delany S, Kumaranayake L, Rees H, Watts C. Are targeted HIV prevention activities cost-effective in high prevalence settings? Results from a sexually transmitted infection treatment project for sex workers in Johannesburg, South Africa. Sex Transm Dis. 2006;33(10 Suppl):S122–32.

    PubMed  Google Scholar 

  92. Dunkle KL, Beksinska ME, Rees VH, Ballard RC, Htun Y, Wilson ML. Risk factors for HIV infection among sex workers in Johannesburg, South Africa. Int J STD AIDS. 2005;16(3):256–61.

    Article  PubMed  CAS  Google Scholar 

  93. Campbell C, Mzaidume Z. Grassroots participation, peer education, and HIV prevention by sex workers in South Africa. Am J Public Health. 2001;91(12):1978–86.

    Article  PubMed  CAS  Google Scholar 

  94. Adu-Oppong A, Grimes RM, Ross MW, Risser J, Kessie G. Social and behavioral determinants of consistent condom use among female commercial sex workers in Ghana. AIDS Educ Prev. 2007;19(2):160–72.

    Article  PubMed  Google Scholar 

  95. Behets FM, Van Damme K, Rasamindrakotroka A, et al. Socio-demographic and behavioural factors associated with high incidence of sexually transmitted infections in female sex workers in Madagascar following presumptive therapy. Sex Health. 2005;2(2):77–84.

    Article  PubMed  Google Scholar 

  96. Umar US, Adekunle AO, Bakare RA. Pattern of condom use among commercial sex workers in Ibadan, Nigeria. Afr J Med Med Sci. 2001;30(4):285–90.

    PubMed  CAS  Google Scholar 

  97. Wechsberg WM, Luseno WK, Lam WK, Parry CD, Morojele NK. Substance use, sexual risk, and violence: HIV prevention intervention with sex workers in Pretoria. AIDS Behav. 2006;10(2):131–7.

    Article  PubMed  Google Scholar 

  98. Gallo MF, Behets FM, Steiner MJ, et al. Prostate-specific antigen to ascertain reliability of self-reported coital exposure to semen. Sex Transm Dis. 2006;33(8):476–9.

    Article  PubMed  Google Scholar 

  99. Gallo MF, Behets FM, Steiner MJ, et al. Validity of self-reported ‘safe sex’ among female sex workers in Mombasa, Kenya—PSA analysis. Int J STD AIDS. 2007;18(1):33–8.

    Article  PubMed  CAS  Google Scholar 

  100. Zachariah R, Harries AD, Buhendwa L, Spielman MP, Chantulo A, Bakali E. Acceptability and technical problems of the female condom amongst commercial sex workers in a rural district of Malawi. Trop Doct. 2003;33(4):220–4.

    PubMed  CAS  Google Scholar 

  101. Outwater A, Nkya L, Lwihula G, et al. Patterns of partnership and condom use in two communities of female sex workers in Tanzania. J Assoc Nurses AIDS Care. 2000;11(4):46–54.

    Article  PubMed  CAS  Google Scholar 

  102. Varga CA. Coping with HIV/AIDS in Durban’s commercial sex industry. AIDS Care. 2001;13(3):351.

    Article  PubMed  CAS  Google Scholar 

  103. Lowndes CM, Alary M, Labbe AC, et al. Interventions among male clients of female sex workers in Benin, West Africa: an essential component of targeted HIV preventive interventions. Sex Transm Infect. 2007;83(7):577–81.

    Article  PubMed  CAS  Google Scholar 

  104. Côté AM, Sobela F, Dzokoto A, et al. Transactional sex is the driving force in the dynamics of HIV in Accra, Ghana. AIDS. 2004;18(6):917–25.

    Article  PubMed  Google Scholar 

  105. Connolly CA, Ramjee G, Sturm AW, Abdool Karim SS. Incidence of sexually transmitted Infections among HIV-positive sex workers in KwaZulu-Natal, South Africa. Sex Transm Dis. 2002;29(11):721–4.

    Article  PubMed  Google Scholar 

  106. Dandona R, Dandona L, Kumar GA, Gutierrez JP, McPherson S, Bertozzi SM. HIV testing among female sex workers in Andhra Pradesh, India. AIDS. 2005;19(17):2033–6.

    Article  PubMed  Google Scholar 

  107. Inciardi JA, Surratt HL, Kurtz SP, Weaver JC. The effect of serostatus on HIV risk behaviour change among women sex workers in Miami, Florida. AIDS Care. 2005;17(Suppl 1):S88–101.

    Article  PubMed  Google Scholar 

  108. McClelland RS, Hassan WM, Lavreys L, et al. HIV-1 acquisition and disease progression are associated with decreased high-risk sexual behaviour among Kenyan female sex workers. AIDS. 2006;20(15):1969–73.

    Article  PubMed  Google Scholar 

  109. Sherr L, Lopman B, Kakowa M, et al. Voluntary counselling and testing: uptake, impact on sexual behaviour, and HIV incidence in a rural Zimbabwean cohort. AIDS. 2007;21(7):851–60.

    Article  PubMed  Google Scholar 

  110. Riedner G, Hoffmann O, Rusizoka M, et al. Decline in sexually transmitted infection prevalence and HIV incidence in female barworkers attending prevention and care services in Mbeya Region, Tanzania. AIDS. 2006;20(4):609–15.

    Article  PubMed  Google Scholar 

  111. WHO, UNAIDS, UNICEF. Towards universal access: scaling up priority HIV/AIDS interventions in the health sector: progress report. 2009 [cited 20 May 2010]. Available from: http://www.who.int/hiv/pub/tuapr_2009_en.pdf.

  112. Chersich MF, Rees HV, Scorgie F, Martin G. Enhancing global control of alcohol to reduce unsafe sex and HIV in sub-Saharan Africa. Glob Health. 2009;5:16.

    Article  Google Scholar 

  113. Chersich MF, Luchters SM, Malonza IM, Mwarogo P, King’ola N, Temmerman M. Heavy episodic drinking among Kenyan female sex workers is associated with unsafe sex, sexual violence and sexually transmitted infections. Int J STD AIDS. 2007;18(11):764–9.

    Article  PubMed  CAS  Google Scholar 

  114. Fisher JC, Cook PA, Sam NE, Kapiga SH. Patterns of alcohol use, problem drinking, and HIV infection among high-risk African women. Sex Transm Dis. 2008;35(6):537–44.

    Article  PubMed  Google Scholar 

  115. Trotter H. Sugar girls and seamen—a journey into the world of dockside prostitution in South Africa. Auckland Park: Jacana media (Pty) Ltd; 2008.

    Google Scholar 

  116. Yadav G, Saskin R, Ngugi E, et al. Associations of sexual risk taking among Kenyan female sex workers after enrollment in an HIV-1 prevention trial. J Acquir Immune Defic Syndr. 2005;38(3):329–34.

    PubMed  Google Scholar 

  117. Behets FM, Rasolofomanana JR, Van Damme K, et al. Evidence-based treatment guidelines for sexually transmitted infections developed with and for female sex workers. Trop Med Int Health. 2003;8(3):251–8.

    Article  PubMed  Google Scholar 

  118. Feldblum PJ, Hatzell T, Van Damme K, Nasution M, Rasamindrakotroka A, Grey TW. Results of a randomised trial of male condom promotion among Madagascar sex workers. Sex Transm Infect. 2005;81(2):166–73.

    Article  PubMed  CAS  Google Scholar 

  119. van der Elst EM, Okuku HS, Nakamya P, et al. Is audio computer-assisted self-interview (ACASI) useful in risk behaviour assessment of female and male sex workers, Mombasa, Kenya? PLoS One. 2009;4(5):e5340.

    Article  PubMed  CAS  Google Scholar 

  120. Ramjee G, Williams B, Gouws E, Van Dyck E, De Deken B, Karim SA. The impact of incident and prevalent herpes simplex virus-2 infection on the incidence of HIV-1 infection among commercial sex workers in South Africa. J Acquir Immune Defic Syndr. 2005;39(3):333–9.

    Article  PubMed  Google Scholar 

  121. van Loggerenberg F, Mlisana K, Williamson C, et al. Establishing a cohort at high risk of HIV infection in South Africa: challenges and experiences of the CAPRISA 002 acute infection study. PLoS One. 2008;3(4):e1954.

    Article  PubMed  CAS  Google Scholar 

  122. Verma R, Shekhar A, Khobragade S, et al. Scale-up and coverage of Avahan: a large-scale HIV-prevention programme among female sex workers and men who have sex with men in four Indian states. Sex Transm Infect. 2010;86(Suppl 1):i76–82.

    Article  PubMed  Google Scholar 

  123. Geibel S, van der Elst EM, King’ola N, et al. ‘Are you on the market?’: a capture–recapture enumeration of men who sell sex to men in and around Mombasa, Kenya. AIDS. 2007;21:1349–54.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors acknowledge the World Health Organisation for funding this review and thank Marlise Richter for her assistance in conducting the review, and Richard Steen for his insightful inputs on the paper.

Author information

Authors and Affiliations

  1. Maternal, Adolescent and Child Health (MatCH), Department of Obstetrics and Gynaecology, University of the Witwatersrand, Johannesburg, 155 Juniper Road, Overport, 4091, Durban, South Africa

    Fiona Scorgie

  2. Centre for Health Policy, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa

    Matthew F. Chersich

  3. International Centre for Reproductive Health, Department of Obstetrics and Gynaecology, Ghent University, Ghent, Belgium

    Matthew F. Chersich

  4. World Health Organisation Regional Office for Africa, Brazzaville, Democratic Republic of the Congo

    Innocent Ntaganira & Frank Lule

  5. Department of HIV/AIDS, World Health Organization, Geneva, Switzerland

    Antonio Gerbase & Ying-Ru Lo

Authors
  1. Fiona Scorgie
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Matthew F. Chersich
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Innocent Ntaganira
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Antonio Gerbase
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Frank Lule
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ying-Ru Lo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fiona Scorgie.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 970 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Scorgie, F., Chersich, M.F., Ntaganira, I. et al. Socio-Demographic Characteristics and Behavioral Risk Factors of Female Sex Workers in Sub-Saharan Africa: A Systematic Review. AIDS Behav 16, 920–933 (2012). https://doi.org/10.1007/s10461-011-9985-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-011-9985-z

Keywords

Search

Navigation