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. 2020 Dec;10(4):351-358.
doi: 10.2991/jegh.k.200603.001. Epub 2020 Jun 19.

HIV Prevalence, Risk Factors for Infection, and Uptake of Prevention, Testing, and Treatment among Female Sex Workers in Namibia

Anna Jonas  1 , Sadhna V Patel  2   3 , Frieda Katuta  1 , Andrew D Maher  4 , Karen M Banda  1 , Krysta Gerndt  4 , Ismelda Pietersen  1 , Neia Menezes de Prata  2   3 , Nicholus Mutenda  1 , Tuli Nakanyala  1 , Esme Kisting  1 , Brown Kawana  4 , Ann-Marie Nietschke  1 , Dimitri Prybylski  2   3 , Willi McFarland  4 , David W Lowrance  2   3
Affiliations

HIV Prevalence, Risk Factors for Infection, and Uptake of Prevention, Testing, and Treatment among Female Sex Workers in Namibia

Anna Jonas et al. J Epidemiol Glob Health. 2020 Dec.

Abstract

Background: In most settings, Female Sex Workers (FSW) bear a disproportionate burden of Human Immunodeficiency Virus (HIV) disease worldwide. Representative data to inform the development of behavioral and biomedical interventions for FSW in Namibia have not been published.

Objectives: Our objectives were to measure HIV prevalence, identify risk factors for infection, and describe uptake of prevention, testing, and treatment among FSW in Namibia.

Methods: We conducted cross-sectional surveys using Respondent-driven Sampling (RDS) in the Namibian cities of Katima Mulilo, Oshikango, Swakopmund/Walvis Bay, and Windhoek. Participating FSW completed behavioral questionnaires and rapid HIV testing.

Results: City-specific ranges of key indicators were: HIV prevalence (31.0-52.3%), reached by prevention programs in the past 12 months (46.9-73.6%), condom use at last sex with commercial (82.1-91.1%) and non-commercial (87.0-94.2%) partners, and tested for HIV within past 12 months or already aware of HIV-positive serostatus (56.9-82.1%). Factors associated with HIV infection varied by site and included: older age, having multiple commercial or non-commercial sex partners, unemployment, being currently out of school, and lower education level. Among HIV-positive FSW, 57.1% were aware of their HIV-positive serostatus and 33.7% were on antiretroviral treatment.

Discussion: Our results indicate extremely high HIV prevalence and low levels of case identification and treatment among FSW in Namibia. Our results, which are the first representative community-based estimates among FSW in Namibia, can inform the scale-up of interventions to reduce the risk for HIV acquisition and onward transmission, including treatment as prevention and pre-exposure prophylaxis.

Keywords: HIV prevalence; Namibia; Sex workers; biobehavioral surveillance; key populations; respondent-driven sampling.

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Conflict of interest statement

The authors declare they have no conflicts of interest.

Figures

Figure 1
Figure 1
Pooled estimates of HIV testing and treatment among HIV-positive female sex workers in four urban areas of Namibia (Katima Mulilo, Oshikango, Swakopmund/Walvis Bay, and Windhoek), 2012–14.
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