Although interventions to control HIV among high-risk groups
such as female sex workers (FSW) are highly recommended in Africa, the contents
and efficacy of these interventions are unclear. We therefore designed a
comprehensive dedicated intervention targeting young FSW and assessed its
impact on HIV incidence in Burkina Faso.
The 321 HIV-uninfected FSW enrolled in the cohort completed
409 person-years of follow-up. No participant seroconverted for HIV during the
study (0/409 person-years), whereas the expected modelled number of HIV
infections were 5.05/409 person-years (95% CI, 5.01–5.08) or 1.23 infections
per 100 person-years (p=0.005).
This null incidence was related to a reduction in the number of regular
partners and regular clients, and by an increase in consistent condom use with
casual clients and with
regular clients.
Combining peer-based prevention and care within the same
setting markedly reduced the HIV incidence among young FSW in Burkina Faso,
through reduced risky behaviours.
Table 1
Baseline participant characteristics and comparison with potentially eligible female sex workers who missed their enrolment visit in Ouagadougou
| Enrolled N=321 | Eligible but not enrolled N=118 | ||
|---|---|---|---|
| n (%) or median [IQR] | N (%) or median [IQR] | p | |
| Socio-demographic characteristics | |||
| Age (years) | 21 [19–23] | 20 [19–23] | 0.42 |
| Marital status (married or cohabiting) | 109 (34) | 31 (26) | 0.13 |
| Sex work status | <0.001 | ||
| Professional | 121 (38) | 23 (20) | |
| Non-professional | 200 (62) | 94 (80) | |
| Education | 0.29 | ||
| None | 87 (27) | 32 (27) | |
| 1–6 years (primary) | 145 (45) | 45 (38) | |
| ≥7 years (secondary or superior) | 89 (28) | 41 (35) | |
| Median monthly income (€) | 91 [53–149] | 63 [38–114] | <0.001 |
| Sex work is the main income source | 211 (66) | 60 (51) | 0.003 |
| Drug and alcohol consumption | |||
| Druga consumption | 14 (4) | – | – |
| Any alcohol consumption | 202 (63) | 68 (58) | 0.37 |
| Previous HIV-testing | 231 (72) | 74 (63) | 0.06 |
| Child desire | 67 (21) | 25 (21) | 1.00 |
| Sexual behaviours | |||
| Age of sex debut (years) | 16 [15–18] | 17 [15–18] | 0.04 |
| Duration of sex work (years) | 1 [0.1–3.0] | 1 [0.0–2.0] | <0.001 |
| Number of casual clients (previous week) | 2 [1–3] | 1 [1–1] | 0.01 |
| >1 regular clients (last month) | 136 (42) | 27 (23) | <0.001 |
| >1 regular partner (last month) | 59 (19) | 21 (18) | 0.88 |
| >1 previous pregnancy | 93 (29) | 22 (19) | 0.03 |
| Always condom use with casual clients | 273 (95) | 86 (93) | 0.45 |
| Always condom use with regular clients | 150 (77) | 31 (70) | 0.43 |
| Always condom use with regular partner | 128 (50) | 59 (56) | 0.29 |
| Vaginal infections | |||
| Vaginal candidiasis | 36 (13) | 15 (16) | 0.38 |
| Bacterial vaginosis | 37 (13) | 12 (13) | 0.73 |
| STI | |||
| Trichomoniasis vaginalis | 8 (3) | 3 (4) | 1.00 |
| HSV-2 infection | 91 (28) | – | – |
aInclude cannabis, volatile solvents, hallucinogens and amphetamines.
By: Isidore T Traore,§,1 Nicolas Meda,1,2 Noelie M Hema,3 Djeneba Ouedraogo,3 Felicien Some,3 Roselyne Some,3 Josiane Niessougou,3 Anselme Sanon,1 Issouf Konate,1 Philippe Van De Perre,4,5 Philippe Mayaud,6 and Nicolas Nagot4,5
1Department of Clinical Research, Centre Muraz, Bobo-Dioulasso, Burkina Faso, West Africa
2Department of Public Health, Centre Muraz, Bobo-Dioulasso, Burkina Faso, West Africa
3Centre of International Research for Health, University of Ouagadougou, Ouagadougou, Burkina Faso, West Africa
4UMR 1058, INSERM/University of Montpellier/EFS, Montpellier, France
5CHRU Montpellier, Montpellier, France
6Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
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