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JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0b013e31826dfb41
Epidemiology and Prevention

Sexual Risk Behaviors and HIV Among Female Sex Workers in Nigeria

Eluwa, George I. MBBS, MS*; Strathdee, Steffanie A. PhD; Adebajo, Sylvia B. MBBS, MPH, MS*; Ahonsi, Babatunde PhD*; Azeez, Aderemi MBBS, MPH; Anyanti, Jennifer MBBS, MPH§

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Abstract

Background: Female sex workers (FSWs) account for about 20% of new HIV infections in Nigeria. We estimated the change in HIV prevalence and sexual risk behaviors between 2 consecutive rounds of integrated biological and behavioral surveillance surveys (IBBSSs) and determined correlates of HIV transmission among FSWs.

Methods: In 2007 and 2010, HIV prevalence and risk behavior data on brothel-based (BB) and non–brothel-based (NBB) FSWs from the integrated biological and behavioral surveillance survey were evaluated in 6 Nigerian states. Logistic regression was used to identify correlates of HIV infection.

Results: A total of 2897 and 2963 FSWs were surveyed in 2007 and 2010, respectively. Overall HIV prevalence decreased in 2010 compared to 2007 (20% vs. 33%; P < 0.001), with similar magnitude of declines among BB-FSW (23% vs. 37%; P < 0.0001) and NBB-FSW (16% vs. 28%; P < 0.0001). Consistent condom use with boyfriends in the last 12 months was lower in 2010 compared to 2007 overall (23% vs. 25%; P = 0.02) and among BB-FSWs (17% vs. 23%; P < 0.01] while NBB-FSWs showed a marginal increase (30% vs. 27%; P = 0.08). FSWs residing in the Federal Capital Territory [adjusted odds ratio (AOR): 1.74 (1.34 − 2.27)] and Kano state [AOR: 2.07 (1.59 − 2.70)] were more likely to be HIV-positive while FSWs recruited in 2010 [AOR: 0.81 (0.77–0.85)] and those who had completed secondary education [AOR: 0.70 (0.60–0.80)] were less likely to be HIV-positive.

Conclusions: Results suggest significant progress in reducing the burden of HIV among FSWs in Nigeria, although low condom use with boyfriends continued to be a potential bridge between FSWs and the general population. Venue-based prevention programs are needed to improve safer sex practices among BB-FSWs.

© 2012 Lippincott Williams & Wilkins, Inc.

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