Remaining Gap in HIV Testing Uptake Among Female Sex Workers in Iran

Abstract

We estimated the prevalence of recent HIV testing (i.e., having an HIV test during the last 12 months and knew the results) among 1295 HIV-negative Iranian female sex workers (FSW) in 2015. Overall, 70.4% (95% confidence intervals: 59.6, 79.3) of the participants reported a recent HIV testing. Concerns about their HIV status (83.2%) was reported as the most common reason for HIV testing. Incarceration history, having >5 paying partners, having >1 non-paying partner, receiving harm reduction services, utilizing healthcare services, and knowing an HIV testing site were significantly associated with recent HIV testing. In contrast, outreach participants, having one non-paying sexual partner, and self-reported inconsistent condom use reduced the likelihood of recent HIV testing. HIV testing uptake showed a ~2.5 times increase among FSW since 2010. While these findings are promising and show improvement over a short period, HIV testing programs should be expanded particularly through mobile and outreach efforts.

Keywords: Female sex workers; HIV testing; Harm reduction; Iran; Surveillance.

Fig. 1

Cities included in the bio-behavioral surveillance survey of female sex workers in Iran, 2015

Fig. 2. Final analytic sample flowchart

Neg: HIV Negative; Pos: HIV Positive; ND: No Data; NR: Not Remember; NA: No Answer; a) Checked via rapid test; b) Did not receive, did not know, no answer; c) These two people reported they were positive while their rapid test was negative, then excluded; Grey color circles were excluded from the analysis; d) This is the outcome variable of the current study under consideration: Code 1: Those who self-reported having a recent HIV test and knew the result of the test (i.e., had a recent HIV test result); Code 0: Those who either had never tested for HIV or had tested for HIV but not in the past year, or had tested for HIV in the past year but did not know their test results (i.e., did not have a recent HIV test result); e) Removed

Fig. 3

The prevalence of “lifetime HIV testing” and “past year HIV testing” among female sex workers in Iran in the two bio-behavioral surveillance surveys in 2010 (n=715; Ref:[23]) and 2015 (n=1295).