Journal of Epidemiology and Global Health

In Press, Corrected Proof, Available Online: 19 June 2020

HIV Prevalence, Risk Factors for Infection, and Uptake of Prevention, Testing, and Treatment among Female Sex Workers in Namibia

Authors
Anna Jonas1, Sadhna V. Patel2, 3, ORCID, Frieda Katuta1, Andrew D. Maher4, *, ORCID, Karen M. Banda1, Krysta Gerndt4, Ismelda Pietersen1, Neia Menezes de Prata2, 3, Nicholus Mutenda1, Tuli Nakanyala1, ORCID, Esme Kisting1, Brown Kawana4, Ann-Marie Nietschke1, Dimitri Prybylski2, 3, Willi McFarland4, David W. Lowrance2, 3, ORCID
1Ministry of Health and Social Services, Windhoek, Namibia
2Division of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Windhoek, Namibia
3Division of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Atlanta, USA
4University of California San Francisco, Institute for Global Health Sciences, San Francisco, USA
*Corresponding author. Email: Andrew.maher@ucsf.edu
Corresponding Author
Andrew D. Maher
Received 22 March 2020, Accepted 21 May 2020, Available Online 19 June 2020.
DOI
https://doi.org/10.2991/jegh.k.200603.001How to use a DOI?
Keywords
Sex workers, HIV prevalence, key populations, respondent-driven sampling, biobehavioral surveillance, Namibia
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.

Copyright
© 2020 The Authors. Published by Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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Journal
Journal of Epidemiology and Global Health
Publication Date
2020/06
ISSN (Online)
2210-6014
ISSN (Print)
2210-6006
DOI
https://doi.org/10.2991/jegh.k.200603.001How to use a DOI?
Copyright
© 2020 The Authors. Published by Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Cite this article

TY  - JOUR
AU  - Anna Jonas
AU  - Sadhna V. Patel
AU  - Frieda Katuta
AU  - Andrew D. Maher
AU  - Karen M. Banda
AU  - Krysta Gerndt
AU  - Ismelda Pietersen
AU  - Neia Menezes de Prata
AU  - Nicholus Mutenda
AU  - Tuli Nakanyala
AU  - Esme Kisting
AU  - Brown Kawana
AU  - Ann-Marie Nietschke
AU  - Dimitri Prybylski
AU  - Willi McFarland
AU  - David W. Lowrance
PY  - 2020
DA  - 2020/06
TI  - HIV Prevalence, Risk Factors for Infection, and Uptake of Prevention, Testing, and Treatment among Female Sex Workers in Namibia
JO  - Journal of Epidemiology and Global Health
SN  - 2210-6014
UR  - https://doi.org/10.2991/jegh.k.200603.001
DO  - https://doi.org/10.2991/jegh.k.200603.001
ID  - Jonas2020
ER  -