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Reconceptualizing the HIV epidemiology and prevention needs of Female Sex Workers (FSW) in Swaziland
- Source :
- PLoS ONE, PLoS ONE, Vol 9, Iss 12, p e115465 (2014)
- Publication Year :
- 2013
-
Abstract
- Background HIV is hyperendemic in Swaziland with a prevalence of over 25% among those between the ages of 15 and 49 years old. The HIV response in Swaziland has traditionally focused on decreasing HIV acquisition and transmission risks in the general population through interventions such as male circumcision, increasing treatment uptake and adherence, and risk-reduction counseling. There is emerging data from Southern Africa that key populations such as female sex workers (FSW) carry a disproportionate burden of HIV even in generalized epidemics such as Swaziland. The burden of HIV and prevention needs among FSW remains unstudied in Swaziland. Methods A respondent-driven-sampling survey was completed between August-October, 2011 of 328 FSW in Swaziland. Each participant completed a structured survey instrument and biological HIV and syphilis testing according to Swazi Guidelines. Results Unadjusted HIV prevalence was 70.3% (n = 223/317) among a sample of women predominantly from Swaziland (95.2%, n = 300/316) with a mean age of 21(median 25) which was significantly higher than the general population of women. Approximately one-half of the FSW(53.4%, n = 167/313) had received HIV prevention information related to sex work in the previous year, and about one-in-ten had been part of a previous research project(n = 38/313). Rape was common with nearly 40% (n = 123/314) reporting at least one rape; 17.4% (n = 23/314)reported being raped 6 or more times. Reporting blackmail (34.8%, n = 113/314) and torture(53.2%, n = 173/314) was prevalent. Conclusions While Swaziland has a highly generalized HIV epidemic, reconceptualizing the needs of key populations such as FSW suggests that these women represent a distinct population with specific vulnerabilities and a high burden of HIV compared to other women. These women are understudied and underserved resulting in a limited characterization of their HIV prevention, treatment, and care needs and only sparse specific and competent programming. FSW are an important population for further investigation and rapid scale-up of combination HIV prevention including biomedical, behavioral, and structural interventions.
- Subjects :
- Gerontology
Male
Viral Diseases
Epidemiology
Psychological intervention
lcsh:Medicine
HIV Infections
Plant Science
Immunodeficiency Viruses
Prevalence
Medicine
lcsh:Science
education.field_of_study
Multidisciplinary
Transmission (medicine)
virus diseases
Prognosis
Socioeconomic Aspects of Health
Infectious Diseases
Medical Microbiology
HIV epidemiology
Viral Pathogens
Female
Research Article
Adult
Disease Ecology
medicine.medical_specialty
Social epidemiology
Adolescent
Population
HIV prevention
Social issues
Microbiology
Infectious Disease Epidemiology
Young Adult
Environmental health
Humans
education
Microbial Pathogens
Sex work
Medicine and health sciences
Preventive medicine
Health Services Needs and Demand
Sex Workers
Population Biology
business.industry
Public health
lcsh:R
HIV
Biology and Life Sciences
Plant Pathology
medicine.disease
Health Care
Public and occupational health
Syphilis
lcsh:Q
business
Eswatini
Risk Reduction Behavior
Follow-Up Studies
Subjects
Details
- ISSN :
- 19326203
- Volume :
- 9
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- PloS one
- Accession number :
- edsair.doi.dedup.....b13b697566b5b106e73c8d6c489080a0