Sex workers (SW) are key populations at an increased risk of
HIV infection. This study aimed to characterise risk-taking behaviours and
assess HIV prevalence among SW in Portugal.
A cross-sectional survey was conducted with 1040 SW using a
participatory research approach. SW were recruited in sex-work locations and
community-based organisation offices. Data were collected through a
questionnaire with trained interviewers. An HIV rapid test was performed in 213
respondents.
Reported HIV prevalence was 8%: 17.6% of man-to-woman
transgenders, 7.4% of women and 5% of men. Of SW reportedly living with HIV,
52.2% reported ever injecting drug use. Inconsistent condom use with clients in
the last month was higher among male SW (26.5%) and with non-paying partners in
the last year was higher among women (71.3%). Among reported HIV-positive SW,
the proportions of inconsistent condom use were high. In multivariate
regression analysis, reported HIV infection remained significantly higher among
transgenders, those older, working outdoors, having ever used
psychoactive substances and earning ≤€1000 per
month. Of those who had an HIV rapid test, 8.9%
were reactive; 73.7% were unaware of their seropositivity.
The HIV infection burden in SW is high. Efforts to promote
HIV testing must be sustained in order to reduce undiagnosed infection. The
diverse risk profiles of SW must be addressed in targeted HIV interventions.
Prevention interventions should be systematically implemented within
most-at-risk subgroups of SW.
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- 1Instituto de Higiene e Medicina Tropical & CMDT, Universidade Nova de Lisboa, Lisboa, Portugal.
- 2GAT-Grupo Português de Activistas sobre o Tratamento de VIH/Sida Pedro Santos, Lisboa, Portugal.
- 3Institute of Public Health of University of Porto, University of Porto Medical School, Porto, Portugal.
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