National and subnational size estimation of female sex workers in Ghana 2020: Comparing 3-source capture-recapture with other approaches

Guure, Chris; Dery, Samuel; Afagbedzi, Seth Kwaku; Tun, Waimar; Weir, Sharon S.; Quaye, Silas; Ankomah, Augustine; Torpey, Kwasi

doi:10.1371/journal.pone.0256949

Cited by 9 publications

(11 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The estimated total number of FSW was 60,049 in Ghana which represents a 0.75% of total female population in Ghana, Bio-Behavioral Survey, 2020. [6] FSW are among the key population in sub-Saharan Africa with a high prevalence of HIV and AIDS mostly because they have multiple sex partners and also engage in unprotected sex. [7] This calls for a more proactive and concerted approaches to effectively and efficiently prevent the spread of HIV and AIDS among FSW and their sexual partners as well as the general population.…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of HIV among female sex workers (FSW) in Ghana is relatively high (4.6%) as against the general population of 1.7% in 2020, Bio-Behavioral Survey report. The estimated total number of FSW was 60,049 in Ghana which represents a 0.75% of total female population in Ghana, Bio-Behavioral Survey, 2020 [6] . FSW are among the key population in sub-Saharan Africa with a high prevalence of HIV and AIDS mostly because they have multiple sex partners and also engage in unprotected sex [7] .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Willingness to take and ever use of pre-exposure prophylaxis among female sex workers in Ghana

Guure¹,

Afagbedzi²,

Torpey

2022

Medicine

Self Cite

View full text Add to dashboard Cite

Pre-exposure prophylaxis (PrEP) is a drug taken by people who are human immunodeficiency virus (HIV) negative and at increased risk of acquiring HIV. It's an effective intervention for HIV prevention. This study seeks to report on the prevalence and determinants of willingness to take and ever use of PrEP among female sex workers (FSW) in Ghana.The data analyzed was obtained from the Integrated Bio-behavioral Surveillance Survey conducted across the 16 regions of Ghana in 2020. Analysis was only performed on FSW who were tested negative to HIV and were sexually active. All included variables were described using medians, percentages, and graphs. Bayesian adjusted odds ratios and 95% credible intervals were estimated using a Bayesian generalized linear model via the binomial family of distributions under the logit link function.Of the 5107 FSW with complete data on willingness to use PrEP, 2737 (53.59%) reported their willingness to take PrEP. Out of the 998 respondents who have ever heard of PrEP only 64 (6.39%) have ever used PrEP. The median age of the respondents was 25 years. People with no comprehensive knowledge of HIV and acquired immunodeficiency syndrome as well as those who entered into the FSW business at age less than 25 years; 946 (34.56%) and 2181 (79.65%) respectively were more willing to take PrEP. FSW from 6 out of the 16 regions of Ghana have never used PrEP. A statistically significant difference between those who entered the sex work at age less than 25 years and those within 25 to 34 years was observed. About 23% of FSWs who had been screened for Sexually Transmitted Infections were more likely to take PrEP.Respondents with lesser age and no comprehensive knowledge of HIV were more willing to take PrEP. The willingness to accept PrEP among FSWs in Ghana is modest. However, utilization is low. Advocacy or intervention programs are required to improve uptake of PrEP.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Willingness to take and ever use of pre-exposure prophylaxis among female sex workers in Ghana

Guure¹,

Afagbedzi²,

Torpey

2022

Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…Research suggests that, compared with two-source CRC, conducting CRC with multiple (three or more) sampling/capture rounds strengthens the design, produces more robust estimates, and relaxes the CRC requirement (assumption) of sample independence [ 23 ]. The CRC method is increasingly being used by several researchers in epidemiology and public health [ 24 - 26 ], and this method was previously used to estimate the national size estimate of FSWs in Rwanda, demonstrating that acquired implementation experiences are crucial for such estimates [ 27 ].…”

Section: Methodsmentioning

confidence: 99%

Population Size Estimation of Men Who Have Sex With Men in Rwanda: Three-Source Capture-Recapture Method

Tuyishime¹,

Kayitesi²,

Musengimana³

et al. 2023

JMIR Public Health Surveill

View full text Add to dashboard Cite

Background Globally, men who have sex with men (MSM) continue to bear a disproportionately high burden of HIV infection. Rwanda experiences a mixed HIV epidemic, which is generalized in the adult population, with aspects of a concentrated epidemic among certain key populations at higher risk of HIV infection, including MSM. Limited data exist to estimate the population size of MSM at a national scale; hence, an important piece is missing in determining the denominators to use in estimates for policy makers, program managers, and planners to effectively monitor HIV epidemic control. Objective The aims of this study were to provide the first national population size estimate (PSE) and geographic distribution of MSM in Rwanda. Methods Between October and December 2021, a three-source capture-recapture method was used to estimate the MSM population size in Rwanda. Unique objects were distributed to MSM through their networks (first capture), who were then tagged according to MSM-friendly service provision (second capture), and a respondent-driven sampling survey was used as the third capture. Capture histories were aggregated in a 2k–1 contingency table, where k indicates the number of capture occasions and “1” and “0” indicate captured and not captured, respectively. Statistical analysis was performed in R (version 4.0.5) and the Bayesian nonparametric latent-class capture-recapture package was used to produce the final PSE with 95% credibility sets (CS). Results We sampled 2465, 1314, and 2211 MSM in capture one, two, and three, respectively. There were 721 recaptures between captures one and two, 415 recaptures between captures two and three, and 422 recaptures between captures one and three. There were 210 MSM captured in all three captures. The total estimated population size of MSM above 18 years old in Rwanda was 18,100 (95% CS 11,300-29,700), corresponding to 0.70% (95% CI 0.4%-1.1%) of total adult males. Most MSM reside in the city of Kigali (7842, 95% CS 4587-13,153), followed by the Western province (2469, 95% CS 1994-3518), Northern province (2375, 95% CS 842-4239), Eastern province (2287, 95% CS 1927-3014), and Southern province (2109, 95% CS 1681-3418). Conclusions Our study provides, for the first time, a PSE of MSM aged 18 years or older in Rwanda. MSM are concentrated in the city of Kigali and are almost evenly distributed across the other 4 provinces. The national proportion estimate bounds of MSM out of the total adult males includes the World Health Organization’s minimum recommended proportion (at least 1.0%) based on 2012 census population projections for 2021. These results will inform denominators to be used for estimating service coverage and fill existing information gaps to enable policy makers and planners to monitor the HIV epidemic among MSM nationally. There is an opportunity for conducting small-area MSM PSEs for subnational-level HIV treatment and prevention interventions.

show abstract

“…To obtain regional and national level estimates, sampling weights were calculated and applied to the dataset following the method recommended by University of California San Francisco (UCSF) in TLS guidance, details of the weighting approach is provided elsewhere (16). Briefly, the weight for combining regional data for national estimates was calculated as the inverse of the probability that the FSW was sampled, adjusting for the proportion of venues sampled in the region.…”

Section: Data Collection Tools Techniques and Statistical Analysismentioning

confidence: 99%

Biobehavioral survey using time location sampling among female sex workers living in Ghana in 2020

Dery,

Guure,

Afagbedzi

et al. 2024

Front. Public Health

Self Cite

View full text Add to dashboard Cite

BackgroundThe HIV epidemic in Ghana is characterized as a mix of a low-level generalized epidemic with significant contributions from transmission among female sex workers (FSW) and their clients. This study seeks to identify and describe key characteristics and sexual behaviors of FSW and estimate the prevalence of HIV, syphilis, gonorrhea, chlamydia, and hepatitis B virus (HBV) among FSW in Ghana.MethodA total of 7,000 FSW were recruited for the study using Time Location Sampling (TLS) approach with 5,990 (85.6%) participants completing both biological and the behavioral aspects of the study. A structured questionnaire was administered to respondents to assess several factors, such as background characteristics, sexual risk behaviors, condom usage, HIV/AIDS knowledge, opinions, and attitudes. Trained staff conducted face-to-face interviews using mobile data collection software (REDCap) after provision of specimens for HIV and STI testing. Descriptive statistics such as medians, ranges, charts, and percentages are performed and presented. Also included, are bivariate analyses to establish relationships between FSW type and other relevant characteristics of the study.ResultsAmong the 7,000 (100%) FSW sampled from all regions, 6,773 took part in the behavioral and 6,217 the biological. There were 783 (11.2%) respondents who took part only in the behavioral and 227 (3.2%) only in the biological. Most were young, with a median age of 26 years, majority had never been married or were widowed/divorced and a quarter had no education or had only primary education. Majority (74.8%) of FSW first sold sex at age 25 years or less with a median age of 20 years. Most (84.8%) of the FSW indicated that they entered sex work for money, either for self or family and had an average of eleven (11) sexual partners per week. More than half (55.2%) of the FSW were new entrants who had been in sex work for less than 5 years before the study. Consistent condom use with paying clients was generally unsatisfactory (71%), and was however, very low (24%) with their intimate partners or boyfriends. Only about half (54.6%) of FSW have been exposed to HIV prevention services in the last three months preceding the survey, and this varies across regions. Overall, comprehensive knowledge about HIV and AIDS was low. Only 35% of FSW had comprehensive knowledge. HIV prevalence was 4.6% and was higher among seaters (brothel-based) and older FSW who had been sex work for a longer period. The HIV prevalence from the previous bio-behavioral survey (BBS) in 2015 and 2011 were estimated to be 6.9 and 11.1%, respectively.ConclusionCompared to the results from the previous studies, the findings give an indication that Ghana is making significant progress in reducing the burden of HIV among FSW in the country. However, risky behaviors such as low consistent condom use, low coverage of HIV services across the regions, and low comprehensive knowledge could reverse the gains made so far. Immediate actions should be taken to expand coverage of HIV services to all locations. Efforts must be made to reach out to the new entrants while also addressing strongly held myths and misconceptions about HIV.

show abstract

National and subnational size estimation of female sex workers in Ghana 2020: Comparing 3-source capture-recapture with other approaches

Cited by 9 publications

References 14 publications

Willingness to take and ever use of pre-exposure prophylaxis among female sex workers in Ghana

Willingness to take and ever use of pre-exposure prophylaxis among female sex workers in Ghana

Population Size Estimation of Men Who Have Sex With Men in Rwanda: Three-Source Capture-Recapture Method

Biobehavioral survey using time location sampling among female sex workers living in Ghana in 2020

Contact Info

Product

Resources

About