Factors Associated with the Absence of HIV-L Infection in Commercial Sex Workers in Addis Ababa, Ethiopia
No Thumbnail Available
Date
1998-12
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Abeba Universty
Abstract
A cross-sectional survey was conducted from August to October 1998 in CSWs attending
STD clinics of two health centers in Addis Ababa, Ethiopia. The objective of the study was to
describe socia-demographic characteristics, behaviors ofCSWs associated with HIV-I
infection. In addition, a sub-group of CSW who remained uninfected despite long years of sex
work was identified and described in more detail. Purposive sampling was used for the survey.
All CSWs willing to participate were interviewed by female nurses. Blood samples were taken
from each respondent for HIV and syphilis test. Characteristics of CSWs were compared
between groups using Chi-square and t test where appropriate. Identification of risk factors for
HIV infection among CSW was performed using univariate and multivariate analysis (logistic
regression model) A total of312 CSWs were enrolled in the study. Their mean age was 25
years. Most of the study participants had little education (786% were less than grade 6). The
mean duration of sex work was 5.5 years. Their workplaces included individually owned
rooms (41.7%), followed by shared rooms (32,5%). Most of participants had already got
instructions about safer sex while working as CSWs, and 43 .0% ofCSWs reported using male
condoms in at least 95% of sexual acts with clients. In multivariate analysis, variables
independently associated with a protective effect against HIV infection were: higher education
(odds ofHIV infection associated with an increase of one category of education: 0.75, 95% CI,
0.58-0.96), instruction by peers about sex work (OR 047,95% CI, 0.23- 0.96) and cleaning
after sex with soap (OR, 049, 95% cr, 0.25-0.94). Variables independently associated with an
increase in risk of HI V infection were: age 25-29 years (OR, reference category 15-19 years,
3.24,95% CI, 106-9.95), sharing rooms with other sex workers (OR, 3.33, 95%CI, 130-8.5 1),
genital bleeding after sex (OR, 2.34, 95% CI, 101-541), and history of genital ulcer in the past
years (OR, 2.89, 95% CI, 1.39-5.99). There was no association between number of years of
sex work and HIV serostatus. Twenty five sex workers had more than five years of sex work
and remained HIV negative. HIV prevalence was remarkably high (80.3%) among sex workers
in Addis Ababa. Based on the results of this study, we recommend the strengthening of peer
education programs and of early diagnosis and treatment of STDs. The protective effect of
cleansing using soap after sex should be explored further On the long run, creating alternative
employment opportunities to sex workers should be strongly supported.
Description
Keywords
Factors Associated with the Absence of HIV-L Infection