Abstract
Background
In most settings, Female Sex Workers (FSW) bear a disproportionate burden of Human Immunodeficiency Virus (HIV) disease worldwide. Representative data to inform the development of behavioral and biomedical interventions for FSW in Namibia have not been published.
Objectives
Our objectives were to measure HIV prevalence, identify risk factors for infection, and describe uptake of prevention, testing, and treatment among FSW in Namibia.
Methods
We conducted cross-sectional surveys using Respondent-driven Sampling (RDS) in the Namibian cities of Katima Mulilo, Oshikango, Swakopmund/Walvis Bay, and Windhoek. Participating FSW completed behavioral questionnaires and rapid HIV testing.
Results
City-specific ranges of key indicators were: HIV prevalence (31.0–52.3%), reached by prevention programs in the past 12 months (46.9–73.6%), condom use at last sex with commercial (82.1–91.1%) and non-commercial (87.0–94.2%) partners, and tested for HIV within past 12 months or already aware of HIV-positive serostatus (56.9–82.1%). Factors associated with HIV infection varied by site and included: older age, having multiple commercial or non-commercial sex partners, unemployment, being currently out of school, and lower education level. Among HIV-positive FSW, 57.1% were aware of their HIV-positive serostatus and 33.7% were on antiretroviral treatment.
Discussion
Our results indicate extremely high HIV prevalence and low levels of case identification and treatment among FSW in Namibia. Our results, which are the first representative community-based estimates among FSW in Namibia, can inform the scale-up of interventions to reduce the risk for HIV acquisition and onward transmission, including treatment as prevention and pre-exposure prophylaxis.
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Data availability statement: The data that support the findings of this study are available upon reasonable request to the Research Ethics Committee of the Ministry of Health and Social Services of Namibia. Request can be submitted to the study co-author, Mr. Nicholus Mutenda [mutendan@nacop.net], Chief Control of Health Programs, Response Monitoring and Evaluation Subdivision, Directorate for Special Programs, Ministry of Health and Social Services of Namibia.
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Jonas, A., Patel, S.V., Katuta, F. et al. HIV Prevalence, Risk Factors for Infection, and Uptake of Prevention, Testing, and Treatment among Female Sex Workers in Namibia. J Epidemiol Glob Health 10, 351–358 (2020). https://doi.org/10.2991/jegh.k.200603.001
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DOI: https://doi.org/10.2991/jegh.k.200603.001