Reconceptualizing the HIV epidemiology and prevention needs of Female Sex Workers (FSW) in Swaziland.
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,...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2014-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4274078?pdf=render |
| _version_ | 1811197715717029888 |
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| author | Stefan Baral Sosthenes Ketende Jessie L Green Ping-An Chen Ashley Grosso Bhekie Sithole Cebisile Ntshangase Eileen Yam Deanna Kerrigan Caitlin E Kennedy Darrin Adams |
| author_facet | Stefan Baral Sosthenes Ketende Jessie L Green Ping-An Chen Ashley Grosso Bhekie Sithole Cebisile Ntshangase Eileen Yam Deanna Kerrigan Caitlin E Kennedy Darrin Adams |
| author_sort | Stefan Baral |
| collection | DOAJ |
| description | 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.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.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.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. |
| first_indexed | 2024-04-12T01:18:59Z |
| format | Article |
| id | doaj.art-abd96d6b55c04045a14d9576451b8069 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-12T01:18:59Z |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-abd96d6b55c04045a14d9576451b80692022-12-22T03:53:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-01912e11546510.1371/journal.pone.0115465Reconceptualizing the HIV epidemiology and prevention needs of Female Sex Workers (FSW) in Swaziland.Stefan BaralSosthenes KetendeJessie L GreenPing-An ChenAshley GrossoBhekie SitholeCebisile NtshangaseEileen YamDeanna KerriganCaitlin E KennedyDarrin AdamsHIV 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.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.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.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.http://europepmc.org/articles/PMC4274078?pdf=render |
| spellingShingle | Stefan Baral Sosthenes Ketende Jessie L Green Ping-An Chen Ashley Grosso Bhekie Sithole Cebisile Ntshangase Eileen Yam Deanna Kerrigan Caitlin E Kennedy Darrin Adams Reconceptualizing the HIV epidemiology and prevention needs of Female Sex Workers (FSW) in Swaziland. PLoS ONE |
| title | Reconceptualizing the HIV epidemiology and prevention needs of Female Sex Workers (FSW) in Swaziland. |
| title_full | Reconceptualizing the HIV epidemiology and prevention needs of Female Sex Workers (FSW) in Swaziland. |
| title_fullStr | Reconceptualizing the HIV epidemiology and prevention needs of Female Sex Workers (FSW) in Swaziland. |
| title_full_unstemmed | Reconceptualizing the HIV epidemiology and prevention needs of Female Sex Workers (FSW) in Swaziland. |
| title_short | Reconceptualizing the HIV epidemiology and prevention needs of Female Sex Workers (FSW) in Swaziland. |
| title_sort | reconceptualizing the hiv epidemiology and prevention needs of female sex workers fsw in swaziland |
| url | http://europepmc.org/articles/PMC4274078?pdf=render |
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