HIV testing behaviour and HIV prevalence among female sex workers in Ukraine: Findings from an Integrated Bio-Behavioural Survey, 2013-2014

Anna Tokar, Iana Sazonova, Sharmistha Mishra, Pavlo Smyrnov, Tetiana Saliuk, Jeffrey V. Lazarus, Jacqueline E.W. Broerse, Maria Roura, James Blanchard, Marissa L. Becker

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Objectives: Ukraine has one of the largest HIV epidemics in Europe, with high prevalence among female sex workers (FSWs). We aimed to identify factors associated with HIV testing and receipt of the test result in the last 12 months, HIV prevalence and self-reported positive status among FSWs in Ukraine. Methods: We used data from an Integrated Bio-Behavioural Survey among FSWs conducted in 2013-2014. The survey methodology combined three sampling strategies: time and location sampling, respondent-driven sampling and key informant recruitment. We used multivariable regression to identify factors associated with self-reported HIV testing in the last 12 months, HIV prevalence and self-reported positive status among FSWs living with HIV. Explored factors included: age, age at first sex, age at entry into sex work, education, marital status, employment status beside sex work, condom use with last paying or non-paying sexual partner, drug or alcohol consumption and sex work venue. Results: Recent HIV testing was low overall with only 63.2% of FSWs reported having tested and received their test result in the last 12 months prior to the survey. HIV prevalence was 7.1% overall, but only 45.0% of FSWs living with HIV were aware of their HIV status. Testing in the last 12 months with receipt of test result was less common among FSWs who used drugs ever in life (adjusted OR (AOR) 0.7, 95% CI 0.6 to 0.9), women soliciting clients indoors (AOR 0.8, 95% CI 0.7 to 0.9) and those not using a condom with last paying sexual partner (AOR 0.3, 95% CI 0.2 to 0.5). HIV positivity was associated with history of ever using drugs (AOR 2.3, 95% CI 1.4 to 3.6) and soliciting clients outdoors (AOR 1.5, 95% CI 1.1 to 2.0). Women working indoors were less aware of their positive status (AOR 0.1, 95% CI 0.1 to 0.9). Conclusion: HIV prevalence is high among FSWs in Ukraine, and testing and knowledge of one's status remain insufficient. HIV testing programmes need to expand with strategies to reach specific subgroups of FSWs.

LanguageEnglish
JournalSexually Transmitted Infections
DOIs
Publication statusPublished - 1 Jan 2019

Fingerprint

Ukraine
Sex Workers
HIV
Sex Work
Sexual Partners
Condoms
Surveys and Questionnaires
Pharmaceutical Preparations
Working Women
Sex Education
Age Factors
Marital Status
Alcohol Drinking

Keywords

  • AIDS
  • female sex workers (FSWs)
  • HIV testing
  • Ukraine

Cite this

Tokar, Anna ; Sazonova, Iana ; Mishra, Sharmistha ; Smyrnov, Pavlo ; Saliuk, Tetiana ; Lazarus, Jeffrey V. ; Broerse, Jacqueline E.W. ; Roura, Maria ; Blanchard, James ; Becker, Marissa L. / HIV testing behaviour and HIV prevalence among female sex workers in Ukraine : Findings from an Integrated Bio-Behavioural Survey, 2013-2014. In: Sexually Transmitted Infections. 2019.
@article{bf54b351802f4e0995ac2ab9570eeb56,
title = "HIV testing behaviour and HIV prevalence among female sex workers in Ukraine: Findings from an Integrated Bio-Behavioural Survey, 2013-2014",
abstract = "Objectives: Ukraine has one of the largest HIV epidemics in Europe, with high prevalence among female sex workers (FSWs). We aimed to identify factors associated with HIV testing and receipt of the test result in the last 12 months, HIV prevalence and self-reported positive status among FSWs in Ukraine. Methods: We used data from an Integrated Bio-Behavioural Survey among FSWs conducted in 2013-2014. The survey methodology combined three sampling strategies: time and location sampling, respondent-driven sampling and key informant recruitment. We used multivariable regression to identify factors associated with self-reported HIV testing in the last 12 months, HIV prevalence and self-reported positive status among FSWs living with HIV. Explored factors included: age, age at first sex, age at entry into sex work, education, marital status, employment status beside sex work, condom use with last paying or non-paying sexual partner, drug or alcohol consumption and sex work venue. Results: Recent HIV testing was low overall with only 63.2{\%} of FSWs reported having tested and received their test result in the last 12 months prior to the survey. HIV prevalence was 7.1{\%} overall, but only 45.0{\%} of FSWs living with HIV were aware of their HIV status. Testing in the last 12 months with receipt of test result was less common among FSWs who used drugs ever in life (adjusted OR (AOR) 0.7, 95{\%} CI 0.6 to 0.9), women soliciting clients indoors (AOR 0.8, 95{\%} CI 0.7 to 0.9) and those not using a condom with last paying sexual partner (AOR 0.3, 95{\%} CI 0.2 to 0.5). HIV positivity was associated with history of ever using drugs (AOR 2.3, 95{\%} CI 1.4 to 3.6) and soliciting clients outdoors (AOR 1.5, 95{\%} CI 1.1 to 2.0). Women working indoors were less aware of their positive status (AOR 0.1, 95{\%} CI 0.1 to 0.9). Conclusion: HIV prevalence is high among FSWs in Ukraine, and testing and knowledge of one's status remain insufficient. HIV testing programmes need to expand with strategies to reach specific subgroups of FSWs.",
keywords = "AIDS, female sex workers (FSWs), HIV testing, Ukraine",
author = "Anna Tokar and Iana Sazonova and Sharmistha Mishra and Pavlo Smyrnov and Tetiana Saliuk and Lazarus, {Jeffrey V.} and Broerse, {Jacqueline E.W.} and Maria Roura and James Blanchard and Becker, {Marissa L.}",
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HIV testing behaviour and HIV prevalence among female sex workers in Ukraine : Findings from an Integrated Bio-Behavioural Survey, 2013-2014. / Tokar, Anna; Sazonova, Iana; Mishra, Sharmistha; Smyrnov, Pavlo; Saliuk, Tetiana; Lazarus, Jeffrey V.; Broerse, Jacqueline E.W.; Roura, Maria; Blanchard, James; Becker, Marissa L.

In: Sexually Transmitted Infections, 01.01.2019.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - HIV testing behaviour and HIV prevalence among female sex workers in Ukraine

T2 - Sexually Transmitted Infections

AU - Tokar, Anna

AU - Sazonova, Iana

AU - Mishra, Sharmistha

AU - Smyrnov, Pavlo

AU - Saliuk, Tetiana

AU - Lazarus, Jeffrey V.

AU - Broerse, Jacqueline E.W.

AU - Roura, Maria

AU - Blanchard, James

AU - Becker, Marissa L.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objectives: Ukraine has one of the largest HIV epidemics in Europe, with high prevalence among female sex workers (FSWs). We aimed to identify factors associated with HIV testing and receipt of the test result in the last 12 months, HIV prevalence and self-reported positive status among FSWs in Ukraine. Methods: We used data from an Integrated Bio-Behavioural Survey among FSWs conducted in 2013-2014. The survey methodology combined three sampling strategies: time and location sampling, respondent-driven sampling and key informant recruitment. We used multivariable regression to identify factors associated with self-reported HIV testing in the last 12 months, HIV prevalence and self-reported positive status among FSWs living with HIV. Explored factors included: age, age at first sex, age at entry into sex work, education, marital status, employment status beside sex work, condom use with last paying or non-paying sexual partner, drug or alcohol consumption and sex work venue. Results: Recent HIV testing was low overall with only 63.2% of FSWs reported having tested and received their test result in the last 12 months prior to the survey. HIV prevalence was 7.1% overall, but only 45.0% of FSWs living with HIV were aware of their HIV status. Testing in the last 12 months with receipt of test result was less common among FSWs who used drugs ever in life (adjusted OR (AOR) 0.7, 95% CI 0.6 to 0.9), women soliciting clients indoors (AOR 0.8, 95% CI 0.7 to 0.9) and those not using a condom with last paying sexual partner (AOR 0.3, 95% CI 0.2 to 0.5). HIV positivity was associated with history of ever using drugs (AOR 2.3, 95% CI 1.4 to 3.6) and soliciting clients outdoors (AOR 1.5, 95% CI 1.1 to 2.0). Women working indoors were less aware of their positive status (AOR 0.1, 95% CI 0.1 to 0.9). Conclusion: HIV prevalence is high among FSWs in Ukraine, and testing and knowledge of one's status remain insufficient. HIV testing programmes need to expand with strategies to reach specific subgroups of FSWs.

AB - Objectives: Ukraine has one of the largest HIV epidemics in Europe, with high prevalence among female sex workers (FSWs). We aimed to identify factors associated with HIV testing and receipt of the test result in the last 12 months, HIV prevalence and self-reported positive status among FSWs in Ukraine. Methods: We used data from an Integrated Bio-Behavioural Survey among FSWs conducted in 2013-2014. The survey methodology combined three sampling strategies: time and location sampling, respondent-driven sampling and key informant recruitment. We used multivariable regression to identify factors associated with self-reported HIV testing in the last 12 months, HIV prevalence and self-reported positive status among FSWs living with HIV. Explored factors included: age, age at first sex, age at entry into sex work, education, marital status, employment status beside sex work, condom use with last paying or non-paying sexual partner, drug or alcohol consumption and sex work venue. Results: Recent HIV testing was low overall with only 63.2% of FSWs reported having tested and received their test result in the last 12 months prior to the survey. HIV prevalence was 7.1% overall, but only 45.0% of FSWs living with HIV were aware of their HIV status. Testing in the last 12 months with receipt of test result was less common among FSWs who used drugs ever in life (adjusted OR (AOR) 0.7, 95% CI 0.6 to 0.9), women soliciting clients indoors (AOR 0.8, 95% CI 0.7 to 0.9) and those not using a condom with last paying sexual partner (AOR 0.3, 95% CI 0.2 to 0.5). HIV positivity was associated with history of ever using drugs (AOR 2.3, 95% CI 1.4 to 3.6) and soliciting clients outdoors (AOR 1.5, 95% CI 1.1 to 2.0). Women working indoors were less aware of their positive status (AOR 0.1, 95% CI 0.1 to 0.9). Conclusion: HIV prevalence is high among FSWs in Ukraine, and testing and knowledge of one's status remain insufficient. HIV testing programmes need to expand with strategies to reach specific subgroups of FSWs.

KW - AIDS

KW - female sex workers (FSWs)

KW - HIV testing

KW - Ukraine

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U2 - 10.1136/sextrans-2018-053684

DO - 10.1136/sextrans-2018-053684

M3 - Article

JO - Sexually Transmitted Infections

JF - Sexually Transmitted Infections

SN - 1368-4973

ER -