West African female sex workers in Mali: reduction in HIV prevalence and differences in risk profiles of sex workers of differing nationalities of origin
| Autor: | Bakary Doumbia, Daouda Diakité, Lisa J. Messersmith, Sékou Traoré, Adama Sangaré, Ouman Dembélé, Flabou Bougoudogo, Amadou Haidara, Joanna Burtner, Jacques Mathieu, Clinton H. Trout, Howard Cabral |
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| Rok vydání: | 2015 |
| Předmět: |
Gerontology
Adult Gonorrhea Population Health Behavior Emigrants and Immigrants HIV Infections Logistic regression Disease cluster Mali Condoms Young Adult Acquired immunodeficiency syndrome (AIDS) Risk Factors medicine Prevalence Humans Pharmacology (medical) education Generalized estimating equation education.field_of_study Unsafe Sex business.industry Nigerians virus diseases medicine.disease Infectious Diseases Female Serostatus business Demography |
| Zdroj: | Journal of acquired immune deficiency syndromes (1999). 68 |
| ISSN: | 1944-7884 |
| Popis: | BACKGROUND: Female sex workers (FSW) in Mali are highly vulnerable to HIV. Their prevalence in 2009 was 9 times higher (24.2%) than that among pregnant women (2.7%). METHODS: Four Integrated HIV/sexually transmitted infection (STI) Surveillance and Behavioral Surveys among FSW in Mali (2000 2003 2006 and 2009) tracked demographic characteristics behavior and HIV and STI prevalence. Logistic regression using generalized estimating equations to control for the cluster effect identified factors associated with HIV-positive serostatus adjusting for potential confounding. RESULTS: Of 2430 FSW 40.8% were Nigerian 36.8% were Malian and 22.4% were from other neighboring countries. Between 2003 and 2009 HIV prevalence dropped from 44.14% to 28.49% (P < 0.0001) among Malians from 21.33% to 12.71% (P = 0.0082) among Nigerians and from 43.42% to 33.67% (P = 0.0442) among "others." Between 2000 and 2009 condom availability increased (89.18%-99.3%; P < 0.0001) as did HIV testing (40%-75%; P < 0.0001). Consistent condom use with clients improved for Malians (72.3%-81.5%; P = 0.0092) but not among Nigerians (92.7%-90.94%; P = 0.8240) and "others" (88.9%-88.48%; P = 0.8452). Consistent condom use with boyfriends was low and improved only for Nigerians (9.8%-28.4%; P = 0.0003). Factors associated with HIV prevalence in the multivariate model were older age study year (2003 and 2006) nationality lack of education mobility STI symptoms gonorrhea prevalence and younger age at first sex. CONCLUSIONS: This study documents progress in the fight against HIV among FSW in Mali. The different vulnerabilities to HIV found for different nationality FSW should be considered in programming and future research. |
| Databáze: | OpenAIRE |
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