Dataset Information

HIV prevalence, sexual risk behaviours and HIV testing among female sex workers in three cities in Sri Lanka: Findings from respondent-driven sampling surveys.

ABSTRACT: Sri Lanka has a low-level HIV epidemic. This study aims to provide evidence on HIV, syphilis and hepatitis B (HBV) prevalence, sexual risk behaviours and utilisation of HIV prevention interventions among female sex workers (FSW) in the cities Colombo, Galle, and Kandy. Using respondent-driven sampling (RDS), we recruited a total of 458 FSW in Colombo, 360 in Galle and 362 in Kandy from November 2017 to March 2018. Participants provided biological specimens for testing for infections and completed a behavioural questionnaire. We found no HIV nor HBV infections in Galle and Kandy, and low HIV (0.4%) and HBV surface antigen (0.6%) prevalence in Colombo. FSW in Colombo had higher positivity on Treponema pallidum-particle agglutination test (8.4%) compared to Galle (2.0%) and Kandy (2.5%). About two thirds of FSW heard of HIV in each of the cities. Around 90% of FSW used condom at last sex with a client in both Colombo and Galle, but considerably less in Kandy (57.1%). However, lower proportion of FSW used condoms every time during sex with clients in the past 30 day: 22.9% of FSW in Colombo, 26.6% in Kandy and 68.4% in Galle. Across cities, 17.5%-39.5% of FSW reported being tested for HIV in the past 12 months or knowing HIV positive status. The commonest reasons for never testing for HIV was not knowing where to test (54.2% in Colombo, 41.8% in Galle, 48.1% in Kandy) followed by inconvenient testing location (23.7% in Colombo and 31.1% in Kandy). HIV has not yet been firmly established among FSW in three cities in Sri Lanka, but the vulnerability towards HIV and STIs is substantial. HIV interventions should be intensified by expanding community-based HIV testing approaches, increasingawareness of HIV risks and addressing socio-structural vulnerabilities of FSW to HIV.

SUBMITTER: Manathunge A

PROVIDER: S-EPMC7529248 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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HIV prevalence, sexual risk behaviours and HIV testing among female sex workers in three cities in Sri Lanka: Findings from respondent-driven sampling surveys.

Manathunge Ariyaratne A Barbaric Jelena J Mestrovic Tomislav T Beneragama Sriyakanthi S Bozicevic Ivana I

PloS one 20201001 10

Sri Lanka has a low-level HIV epidemic. This study aims to provide evidence on HIV, syphilis and hepatitis B (HBV) prevalence, sexual risk behaviours and utilisation of HIV prevention interventions among female sex workers (FSW) in the cities Colombo, Galle, and Kandy. Using respondent-driven sampling (RDS), we recruited a total of 458 FSW in Colombo, 360 in Galle and 362 in Kandy from November 2017 to March 2018. Participants provided biological specimens for testing for infections and complete ...[more]

PMID: 33002081

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Project description:Respondent driven sampling (RDS) is a relatively new method to sample hard-to-reach populations. Until this study, female sex workers (FSWs) in Vietnam were sampled using a variety of methods, including time location sampling (TLS), which may not access the more hidden types of FSWs. This paper presents an analysis from an HIV biological and behavioral surveillance survey to assess the feasibility and effectiveness of RDS to sample FSWs, to determine if RDS can reach otherwise inaccessible FSWs in Vietnam and to compare RDS findings of HIV risk factors with a theoretical TLS. Through face-to-face interviews with FSWs in Ho Chi Minh City (HCMC) and Hai Phong (HP), data were collected about the venues where they most often solicit their clients. These data were used to create three variables to assess whether FSWs solicit their clients in locations that are visible, semi-visible and non-visible. For this analysis, the visible group simulates a sample captured using TLS. Survey results in HIV prevalence and related risk factors and service utilization, adjusted for sampling methodology, were compared across each of the three FSW visibility groups to assess potential bias in TLS relative to RDS. The number of self-reported visible FSWs (HCMC: n=311; HP: n=162) was much larger than those of the semi-visible (HCMC: n=65; HP: n=43) and non-visible (HCMC: n=37; HP: n=10) FSWs in HCMC and HP. Non-visible FSWs in both cities were just as likely as visible and semi-visible FSWs to be HIV positive (HCMC: visible 14.5%, semi-visible 13.8%, non-visible 13.5%, p value = 0.982; HP: visible 35.2%, semi-visible 30.2%, non-visible 30.0%, p value = 0.801), to practice behaviors that put them at risk for contracting and transmitting HIV (injecting drug use-HCMC: visible 13.8%, semi-visible 12.3%, non-visible 5.4%, p value = 0.347; HP: visible 38.9%, semi-visible 23.3%, non-visible 30.0%, p value = 0.378, to have no condom use in the past month -HCMC only: visible 52.7%, semi-visible 63.1%, non-visible 48.6%, p value = 0.249) and to have symptoms of a sexually transmitted infection (STI) in the past year (HCMC: visible 16.1%, semi-visible 12.3%, non-visible 16.2%, p value = 0.742; HP: visible 13.6%, semi-visible 18.6%, non-visible 20.0%, p value = 0.640). There was a difference found among the visible, semi-visible and non-visible groups in HP for no past month condom use (visible 53.1%, semi-visible 79.1%, non-visible 60.0%, p value = 0.009). This study found that RDS was successful at recruiting hidden types of FSWs in Vietnam. Past reports of FSWs in Vietnam have assessed the more visible FSWs as being the most vulnerable and at risk for HIV. Although the number of visible FSWs is much higher than those of the semi and non-visible groups, this study found that the non-visible FSWs are very vulnerable to HIV infection. If prevention programs are targeting and responding to those who are most likely to be assessed (e.g., more visible types of FSWs) then this analysis indicates that a significant proportion of the FSW population at risk for HIV may not be receiving optimal HIV information and services.

Project description:BackgroundEstimates of the sizes of hidden populations, including female sex workers (FSW), men who have sex with men (MSM), and people who inject drugs (PWID), are essential for understanding the magnitude of vulnerabilities, health care needs, risk behaviors, and HIV and other infections.ObjectiveThis article advances the successive sampling-population size estimation (SS-PSE) method by examining the performance of a modification allowing visibility to be jointly modeled with population size in the context of 15 datasets. Datasets are from respondent-driven sampling (RDS) surveys of FSW, MSM, and PWID from three cities in Armenia. We compare and evaluate the accuracy of our imputed visibility population size estimates to those found for the same populations through other unpublished methods. We then suggest questions that are useful for eliciting information needed to compute SS-PSE and provide guidelines and caveats to improve the implementation of SS-PSE for real data.MethodsSS-PSE approximates the RDS sampling mechanism via the successive sampling model and uses the order of selection of the sample to provide information on the distribution of network sizes over the population members. We incorporate visibility imputation, a measure of a person's propensity to participate in the study, given that inclusion probabilities for RDS are unknown and social network sizes, often used as a proxy for inclusion probability, are subject to measurement errors from self-reported study data.ResultsFSW in Yerevan (2012, 2016) and Vanadzor (2016) as well as PWID in Yerevan (2014), Gyumri (2016), and Vanadzor (2016) had great fits with prior estimations. The MSM populations in all three cities had inconsistencies with expert prior values. The maximum low prior value was larger than the minimum high prior value, making a great fit impossible. One possible explanation is the inclusion of transgender individuals in the MSM populations during these studies. There could be differences between what experts perceive as the size of the population, based on who is an eligible member of that population, and what members of the population perceive. There could also be inconsistencies among different study participants, as some may include transgender individuals in their accounting of personal network size, while others may not. Because of these difficulties, the transgender population was split apart from the MSM population for the 2018 study.ConclusionsPrior estimations from expert opinions may not always be accurate. RDS surveys should be assessed to ensure that they have met all of the assumptions, that variables have reached convergence, and that the network structure of the population does not have bottlenecks. We recommend that SS-PSE be used in conjunction with other population size estimations commonly used in RDS, as well as results of other years of SS-PSE, to ensure generation of the most accurate size estimation.

Project description:IntroductionDengue has become a major health problem in globally as well as locally. The delay in health-seeking is significantly associated with complications leading to severe dengue and active engagement of communities needs to minimize the delays in management to control epidemics. The aim of the study was to evaluate the relationship between sociodemographic characteristics and householders' Health-Seeking Behaviours (HSB), Dengue-Prevention Behaviours (DPB), and Community Capacities (CC) for sustained dengue prevention in Sri Lanka, a country with a high dengue endemicity.MethodsA cross-sectional analytical study was carried out in a district with the highest dengue endemicity from January to April 2019. Of the householders, 532 were chosen randomly. A pre-tested, validated, and interviewer-administered questionnaire was used to assess HSB and DPB. The HSB was assessed using three aspects, initial response for fever management, the duration of blood testing and initial response if suspected dengue. The DPB assessment was evaluated using 'waste, outdoor water container, indoor water container, roof gutter and water storage management'. 'Dengue Community Capacity Assessment Tool', with 14 key items was used to assess the level of community capacity for dengue prevention. Out of the total, ≥ 50% was considered as an "adequate" HSB, DPB and CC. Multiple logistic regression was performed to control confounding effects. The results were expressed as adjusted Odds-Ratios (aOR) and 95% Confidence Intervals (CI).ResultsThe response rate was 93.2% (n = 496). Among them, 44.6% (n = 221) had adequate overall HSB, and 19.2% (n = 95) had adequate DPB. Householders who have ≤ 4 family members are 1.74 times (aOR = 1.74; 95% CI: 1.17 - 2.61) more likely to have adequate HSB and 1.85 times (aOR = 1.85; 95% CI: 1.11 - 3.09) more likely to have adequate DPB. The age group of 46 to 70 years' individuals (aOR = 1.74; 95% CI:1.12 - 2.92), and who engaged in employment (aOR = 1.68; 95% CI: 1.05 - 2.67) were more likely to have adequate DPB than the group of 18 to 45 years and the non-employed individuals respectively. Of them, 24.6% (n = 122) perceived that they have adequate CC. The householders who have per-capita income < USD 50 are 1.95 times (aOR = 1.95; 95%CI:1.11 - 3.40) more likely to have adequate CC.ConclusionThe HSB, DPB and CC need to be improved to change the behaviour for sustainable dengue prevention and community capacity-building programmes need to be conducted in the Kurunegala district, Sri Lanka.

Dataset Information

HIV prevalence, sexual risk behaviours and HIV testing among female sex workers in three cities in Sri Lanka: Findings from respondent-driven sampling surveys.

Publications

HIV prevalence, sexual risk behaviours and HIV testing among female sex workers in three cities in Sri Lanka: Findings from respondent-driven sampling surveys.

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