Association of HIV infection and partner’s injection drug use among female sex workers in Dar es Salaam: A respondent-driven sampling survey

Abstract

Background: In Tanzania, data on female sex workers (FSW) are lacking, though sex work is relatively common in Dar es Salaam.

Methods: In 2010, we conducted a cross-sectional study using respondent-driven sampling (RDS) to assess HIV prevalence and associated risk behaviors among FSW in Dar es Salaam. Information on socio-demographic characteristics and sexual and drug risk behaviors was collected through face-to-face interviews. The primary outcome variable was HIV infection determined using an HIV rapid test.

Results: A total of 537 self-identified FSW were recruited into the s tudy. The adjusted estimated prevalence of HIV infection in the target population was 31.4% (95% CI: 25.6-38.5). HIV prevalence was relatively high (46.9% [95% CI: 31.5-61.4]) among FSW who suspected their sexual partners injected drugs; the adjusted odds ratio (AOR) of HIV infection among women who suspected their partners injected drugs was 3.3. HIV prevalence did not differ by partner type, but condom use did differ by partner type (31.6% with nonpaying steady partners, 65.4% with one-time partners, and 59.4% with non-paying casual partners. In addition, each additional year of sex slightly increased risk of HIV infection among FSW (AOR: 0.09).

Conclusion: Results of this study suggest public health interventions, such as safe injection practices for partners of FSW who inject drugs, condom promotion, and target prevention programs for younger FSW, would reduce HIV infections.