Unexpectedly High Injection Drug Use, HIV and Hepatitis C Prevalence Among Female Sex Workers in the Republic of Mauritius

Abstract

Female sex workers (FSW) often have a disproportionately high prevalence of HIV infection and they, along with their clients, are considered a core group contributing to the transmission of HIV in many countries. In 2010, females who reported having vaginal/anal/oral sex in the last 6 months with a male in exchange for money or gifts, aged ≥15 years, and living in Mauritius were recruited into a survey using respondent driven sampling. Consenting females (n = 299) completed a behavioral questionnaire and provided venous blood for HIV, HCV and HBV testing. HIV seroprevalence among FSW was 28.9 % and 43.8 % were infected with HCV; among HIV seropositive FSW, 88.2 % were also infected with HCV. Almost 40 % of FSW reported injecting drugs sometime in their lives and 30.5 % of all FSW reported doing so in the previous 3 months. Among those who ever injected drugs, 82.5 % did so in the past 3 months and among those 60 % reported injecting drugs at least once a day. Among FSW who ever injected drugs, 17.5 % reported sharing a needle at last injection. Regression analyses found injection drug use behaviors to be positively associated with HIV seroprevalence. These findings indicate that FSW, especially those who inject drugs, are at high risk for HIV and HCV infection and transmission and illustrates the need for gender responsive HIV and injection drug use prevention and treatment models that respond to the unique situations that affect this population.

Dual sexual and drug-related predictors of hepatitis C incidence among sex workers in a Canadian setting: gaps and opportunities for scale-up of hepatitis C virus prevention, treatment, and care

“…Although studies with PWID estimate HCV incidence to be between 20–40/100 PY 6 , declining incidence has been demonstrated among PWID in Vancouver and other settings characterized by the scale-up of effective, community-based harm reduction programs 20,21 . To our knowledge, this is the first study to examine HCV incidence in a large cohort of sex workers, complementing the few prior studies that have examined HCV prevalence among sex workers elsewhere 12,22,23 . In comparison with an estimated HCV prevalence of 0.8%-2.8% in the general Canadian population 24,25 , 43% of sex workers were HCV-seropositive.…”

Preventing HIV Infection in Women

“…[30], [29] In Mauritius, for example, IDU accounted for 73% of HIV cases in 2010, and HIV prevalence among IDUs was 47%. [33] In a sample of female sex workers in that country, 40% reported ever having injected drugs, with respective HIV and HCV prevalence among these women of 28.9% and 43.8%, respectively. [33] IDU often results in participation in commercial sex to finance a drug habit, and conversely, sex work may lead to IDU.…”

“…[33] In a sample of female sex workers in that country, 40% reported ever having injected drugs, with respective HIV and HCV prevalence among these women of 28.9% and 43.8%, respectively. [33] IDU often results in participation in commercial sex to finance a drug habit, and conversely, sex work may lead to IDU. Thus, drug use and risky sex emerge as synergistic modes of HIV acquisition for women.…”

Reductions in HIV/STI Incidence and Sharing of Injection Equipment among Female Sex Workers Who Inject Drugs: Results from a Randomized Controlled Trial

“…Considerable overlap between FSW and IDU populations has been documented in parts of Southeast and Central Asia [11], [12], Eastern Europe[13]–[15] Africa [16], Latin America [17] and North America [18], including Mexico [19]. In an earlier study of FSWs in Tijuana and Ciudad (Cd.)…”