Syphilis among Female Sex Workers: Results of Point-of-Care Screening during a Cross-Sectional Behavioral Survey in Burkina Faso, West Africa

Abstract

Background Syphilis among female sex workers (FSW) remains a public health concern due to its potential impact on their health and the possibility of transmission to their clients, partners, and children. Recent data on the prevalence of syphilis in the population in West Africa are scarce. The objective of this study was to measure the seroprevalence of syphilis serological markers among female sex workers in Burkina Faso. Methods We conducted a cross-sectional survey among FSW between February 2013 and May 2014. Participants were recruited using respondent-driven sampling (RDS) methods in five cities of Burkina Faso (Ouagadougou, Bobo-Dioulasso, Koudougou, Ouahigouya, and Tenkodogo). FSW were enrolled and screened for syphilis using a syphilis serological rapid diagnostic test. Data from all cities were analyzed with Stata version 14.0. Results A total of 1045 FSW were screened for syphilis. Participants' mean age was 27.2 ± 0.2 years. The syphilis serological markers were detected in 5.6% (95% CI: 4.4–7.2) of the participants whereas active syphilis was seen in 1.4% (95% CI: 0.9–2.4). RDS weighted prevalence of syphilis serological markers and active syphilis by city were, respectively, estimated to be 0.0% to 11.0% (95% CI: 8.1–14.7) and 0.0% to 2.2% (95% CI: 1.1–4.4). No syphilis markers were found among Ouahigouya FSW. Low education level and high number of clients were factors associated with syphilis markers among the FSW. Conclusion The prevalence of syphilis markers was high during this study among FSW. This highlights the need to reinforce the comprehensive preventive measures and treatment of syphilis in this population.

“I Felt Very Small and Embarrassed by the Health Care Provider When I Requested to be Tested for Syphilis”: Barriers and Facilitators of Regular Syphilis and HIV Testing Among Female Sex Workers in Uganda

“…Forty-eight participants were interviewed across the four cities. The median age was 28 years (interquartile range [IQR], [22][23][24][25][26][27][28][29], and the median duration of sex work was 36 months (IQR 24-54) (Table 1). Fifty two percent had obtained secondary education (≥7 years of education) and 31% had primary or no formal education.…”

HIV and syphilis testing behaviors among heterosexual male and female sex workers in Uganda

“…These policy choices could limit HMSW access to regular syphilis testing unlike FSW who are targeted during testing campaigns or antenatal care [39,41]. Scaling up point-of-care (POC) testing for HIV and syphilis increases uptake of testing services by sex workers [58] and enables early treatment of both diseases [59,60]. The strengths of our study include being the first study (to our knowledge) to evaluate HIV and syphilis testing among HMSW in Uganda and use of the integrated change model to guide the design and analysis of major explanatory variables with reliable item statements (Cronbach's α ≥ 0.7).…”

“…These policy choices could limit HMSW access to regular syphilis testing unlike FSW who are targeted during testing campaigns or antenatal care [ 39 , 41 ]. Scaling up point-of-care (POC) testing for HIV and syphilis increases uptake of testing services by sex workers [ 58 ] and enables early treatment of both diseases [ 59 , 60 ].…”

HIV and Syphilis Testing Behaviors among Heterosexual Male Sex Workers in Uganda

“…These policy choices could limit the opportunities for information on regular syphilis testing among MSW who are not targeted during testing campaigns for FSW (49, 50). Scaling up point-of-care (POC) testing for HIV and syphilis increases uptake of testing services by sex workers (51) and enables early treatment of both diseases (52,53).…”