Estimation of the Population Size of Street- and Venue-Based Female Sex Workers and Sexually Exploited Minors in Rwanda in 2022: 3-Source Capture-Recapture

BackgroundHIV surveillance among key populations is a priority in all epidemic settings. Female sex workers (FSWs) globally as well as in Rwanda are disproportionately affected by the HIV epidemic; hence, the Rwanda HIV and AIDS National Strategic Plan (2018-2024) has adopted...

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Main Authors: Elysee Tuyishime, Eric Remera, Catherine Kayitesi, Samuel Malamba, Beata Sangwayire, Ignace Habimana Kabano, Horacio Ruisenor-Escudero, Tom Oluoch, Angela Unna Chukwu
Format: Article
Language:English
Published: JMIR Publications 2024-03-01
Series:JMIR Public Health and Surveillance
Online Access:https://publichealth.jmir.org/2024/1/e50743
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author Elysee Tuyishime
Eric Remera
Catherine Kayitesi
Samuel Malamba
Beata Sangwayire
Ignace Habimana Kabano
Horacio Ruisenor-Escudero
Tom Oluoch
Angela Unna Chukwu
author_facet Elysee Tuyishime
Eric Remera
Catherine Kayitesi
Samuel Malamba
Beata Sangwayire
Ignace Habimana Kabano
Horacio Ruisenor-Escudero
Tom Oluoch
Angela Unna Chukwu
author_sort Elysee Tuyishime
collection DOAJ
description BackgroundHIV surveillance among key populations is a priority in all epidemic settings. Female sex workers (FSWs) globally as well as in Rwanda are disproportionately affected by the HIV epidemic; hence, the Rwanda HIV and AIDS National Strategic Plan (2018-2024) has adopted regular surveillance of population size estimation (PSE) of FSWs every 2-3 years. ObjectiveWe aimed at estimating, for the fourth time, the population size of street- and venue-based FSWs and sexually exploited minors aged ≥15 years in Rwanda. MethodsIn August 2022, the 3-source capture-recapture method was used to estimate the population size of FSWs and sexually exploited minors in Rwanda. The field work took 3 weeks to complete, with each capture occasion lasting for a week. The sample size for each capture was calculated using shinyrecap with inputs drawn from previously conducted estimation exercises. In each capture round, a stratified multistage sampling process was used, with administrative provinces as strata and FSW hotspots as the primary sampling unit. Different unique objects were distributed to FSWs in each capture round; acceptance of the unique object was marked as successful capture. Sampled FSWs for the subsequent capture occasions were asked if they had received the previously distributed unique object in order to determine recaptures. Statistical analysis was performed in R (version 4.0.5), and Bayesian Model Averaging was performed to produce the final PSE with a 95% credibility set (CS). ResultsWe sampled 1766, 1848, and 1865 FSWs and sexually exploited minors in each capture round. There were 169 recaptures strictly between captures 1 and 2, 210 recaptures exclusively between captures 2 and 3, and 65 recaptures between captures 1 and 3 only. In all 3 captures, 61 FSWs were captured. The median PSE of street- and venue-based FSWs and sexually exploited minors in Rwanda was 37,647 (95% CS 31,873-43,354), corresponding to 1.1% (95% CI 0.9%-1.3%) of the total adult females in the general population. Relative to the adult females in the general population, the western and northern provinces ranked first and second with a higher concentration of FSWs, respectively. The cities of Kigali and eastern province ranked third and fourth, respectively. The southern province was identified as having a low concentration of FSWs. ConclusionsWe provide, for the first time, both the national and provincial level population size estimate of street- and venue-based FSWs in Rwanda. Compared with the previous 2 rounds of FSW PSEs at the national level, we observed differences in the street- and venue-based FSW population size in Rwanda. Our study might not have considered FSWs who do not want anyone to know they are FSWs due to several reasons, leading to a possible underestimation of the true PSE.
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spelling doaj.art-df7762c0dfcb494faa9c9978c9a0a6842024-03-15T14:45:53ZengJMIR PublicationsJMIR Public Health and Surveillance2369-29602024-03-0110e5074310.2196/50743Estimation of the Population Size of Street- and Venue-Based Female Sex Workers and Sexually Exploited Minors in Rwanda in 2022: 3-Source Capture-RecaptureElysee Tuyishimehttps://orcid.org/0000-0002-3600-878XEric Remerahttps://orcid.org/0000-0002-6084-8877Catherine Kayitesihttps://orcid.org/0000-0002-1404-590XSamuel Malambahttps://orcid.org/0000-0001-8087-8849Beata Sangwayirehttps://orcid.org/0009-0004-1739-5747Ignace Habimana Kabanohttps://orcid.org/0000-0003-3473-4558Horacio Ruisenor-Escuderohttps://orcid.org/0000-0002-0367-6976Tom Oluochhttps://orcid.org/0000-0001-9621-5900Angela Unna Chukwuhttps://orcid.org/0000-0001-5596-573X BackgroundHIV surveillance among key populations is a priority in all epidemic settings. Female sex workers (FSWs) globally as well as in Rwanda are disproportionately affected by the HIV epidemic; hence, the Rwanda HIV and AIDS National Strategic Plan (2018-2024) has adopted regular surveillance of population size estimation (PSE) of FSWs every 2-3 years. ObjectiveWe aimed at estimating, for the fourth time, the population size of street- and venue-based FSWs and sexually exploited minors aged ≥15 years in Rwanda. MethodsIn August 2022, the 3-source capture-recapture method was used to estimate the population size of FSWs and sexually exploited minors in Rwanda. The field work took 3 weeks to complete, with each capture occasion lasting for a week. The sample size for each capture was calculated using shinyrecap with inputs drawn from previously conducted estimation exercises. In each capture round, a stratified multistage sampling process was used, with administrative provinces as strata and FSW hotspots as the primary sampling unit. Different unique objects were distributed to FSWs in each capture round; acceptance of the unique object was marked as successful capture. Sampled FSWs for the subsequent capture occasions were asked if they had received the previously distributed unique object in order to determine recaptures. Statistical analysis was performed in R (version 4.0.5), and Bayesian Model Averaging was performed to produce the final PSE with a 95% credibility set (CS). ResultsWe sampled 1766, 1848, and 1865 FSWs and sexually exploited minors in each capture round. There were 169 recaptures strictly between captures 1 and 2, 210 recaptures exclusively between captures 2 and 3, and 65 recaptures between captures 1 and 3 only. In all 3 captures, 61 FSWs were captured. The median PSE of street- and venue-based FSWs and sexually exploited minors in Rwanda was 37,647 (95% CS 31,873-43,354), corresponding to 1.1% (95% CI 0.9%-1.3%) of the total adult females in the general population. Relative to the adult females in the general population, the western and northern provinces ranked first and second with a higher concentration of FSWs, respectively. The cities of Kigali and eastern province ranked third and fourth, respectively. The southern province was identified as having a low concentration of FSWs. ConclusionsWe provide, for the first time, both the national and provincial level population size estimate of street- and venue-based FSWs in Rwanda. Compared with the previous 2 rounds of FSW PSEs at the national level, we observed differences in the street- and venue-based FSW population size in Rwanda. Our study might not have considered FSWs who do not want anyone to know they are FSWs due to several reasons, leading to a possible underestimation of the true PSE.https://publichealth.jmir.org/2024/1/e50743
spellingShingle Elysee Tuyishime
Eric Remera
Catherine Kayitesi
Samuel Malamba
Beata Sangwayire
Ignace Habimana Kabano
Horacio Ruisenor-Escudero
Tom Oluoch
Angela Unna Chukwu
Estimation of the Population Size of Street- and Venue-Based Female Sex Workers and Sexually Exploited Minors in Rwanda in 2022: 3-Source Capture-Recapture
JMIR Public Health and Surveillance
title Estimation of the Population Size of Street- and Venue-Based Female Sex Workers and Sexually Exploited Minors in Rwanda in 2022: 3-Source Capture-Recapture
title_full Estimation of the Population Size of Street- and Venue-Based Female Sex Workers and Sexually Exploited Minors in Rwanda in 2022: 3-Source Capture-Recapture
title_fullStr Estimation of the Population Size of Street- and Venue-Based Female Sex Workers and Sexually Exploited Minors in Rwanda in 2022: 3-Source Capture-Recapture
title_full_unstemmed Estimation of the Population Size of Street- and Venue-Based Female Sex Workers and Sexually Exploited Minors in Rwanda in 2022: 3-Source Capture-Recapture
title_short Estimation of the Population Size of Street- and Venue-Based Female Sex Workers and Sexually Exploited Minors in Rwanda in 2022: 3-Source Capture-Recapture
title_sort estimation of the population size of street and venue based female sex workers and sexually exploited minors in rwanda in 2022 3 source capture recapture
url https://publichealth.jmir.org/2024/1/e50743
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