Sexually transmitted infections and factors associated with risky sexual practices among female sex workers: A cross sectional study in a large Andean city

Abstract

Background There are limited published data on factors related to risky sexual practices (RSP) affecting sexually transmitted infections (STIs) among female sex workers (FSWs) in Ecuador. Methods Cross-sectional study of FSWs presenting for a consultation in a primary health care centre during 2017. A questionnaire was administered to collect information on RSP and potential risk factors including age, membership of an FSW association, self-report of previous STI diagnosis, previous treatment for suspected STI and temporary migration for sex work. Associations between RSP and potential risk factors were estimated by logistic regression. The proportion of STI was estimated from vaginal swabs by real-time PCR for four sexually transmitted pathogens (Neisseria gonorrhoeae, Trichomonas vaginalis, Chlamydia trachomatis, and Mycoplasma genitalium). Results Of 249 FSWs recruited, 22.5% had reported RSPs at least once during sex work. Among FSWs reporting unprotected vaginal sex in the previous three months, 25.5% had at least one other RSP type. 17.6% (95%CI 13.3–22.8) had at least one active STI. Prevalence of co-infections was 2.4% (95%CI 1.1–5.2). In multivariable analysis, RSP was associated with age (adjusted OR 1.06; 95%CI 1.02–1.10), membership of an FSWs association (aOR 3.51; 95%CI 1.60–7.72) and self-reported previous STI (aOR 3.43; 95%CI 1.28–9.17). Conclusions Among a population of female sex workers with high proportion of STIs, increasing age and belonging to an FSWs association was associated with a higher likelihood of engaging in RSP with clients. Engaging with FSWs organisations may reduce the burden of STI among sex workers.

Determinants of sexually transmitted infections among female sex workers in Ethiopia: a count regression model approach

“…This study found that 18.2% of the 6,085 FSWs studied had HIV, 6.2% had syphilis, 2.5% had HBV, and 0.5% had HCV. This study found that at least one STI was found in 23.64% of the FSWs, which is consistent with the findings of previous reports from Ethiopia (15), Mexico (16), and Ecuador (13) where at least 17.6% of FSWs were infected with STIs. Our finding could be a higher estimate because the other studies used polymerase chain reaction (PCR) to test for STIs.…”

“…The prevalence of STIs among FSWs varies by country and across different studies (11, [13][14][15][16]) ranging from 13.3% (14) to 43.2% (11). In Ethiopia, 23% of FSWs reported having one or more STIs (15).…”

Combination of Digital and Conventional Intervention for Sexually Transmitted Infections Prevention among Female Sex Workers

“…Having a high level of knowledge about STIs, including symptoms, modes of transmission, screening, and treatment, encourages the practice of safe sex ( 34 ). The behavior of using condoms consistently, which was lacking before being given health education, is caused by the low level of condom negotiation, especially with regular partners ( 35 ). The condom use rate with regular partners is only 24.1% ( 36 ).…”

Determinants of Inconsistent Condom Use among Female Sex Workers in Ethiopia: Findings from the National Biobehavioral Survey, 2020

“…Studies conducted in Africa, Asia and Latin America have revealed factors that are positively and independently, but variably, associated with inconsistence condom use include increasing age, exposure to voluntarily counseling and testing (VCT), shorter period in commercial sex work, higher education level, knowledge about HIV infection, nonpaying sexual partnership, STIs, and alcohol consumption, among others (3,10,11,(13)(14)(15)(16)(17). However, most of these studies identi ed individual-level risk factors associated with condom use among FSWs and limited to small geographic areas and did not consider environmental factors beyond individual control which might play signi cant roles in enhancing inconsistent condom use.…”