Sexually transmitted infections knowledge, practices and treatment: assessing facility treatment gap among female sex workers in Lagos, Nigeria

Abstract

Background:  Globally as significant progress was made in reducing new cases of viral STI specifically HIV and HPV, new strains of antibiotic resistant STI causing organisms emerged. Key population having high burden of bacterial STI also have high prevalence and incidence of HIV. This study was carried out to assess knowledge about STI, HIV and HCT as well as to identify prevention and treatment practices for STI among brothel based female sex workers in two urban communities in Lagos state.

Materials and Method: A cross sectional descriptive study design was used; sample size of 300 was calculated. The study population is females who sell sex in brothels in two communities in Lagos. Simple random sampling was used to select 15 brothels from the list of brothels compiled in each local government through community mapping. The rooms in the brothel were the unit of sampling, 10 female sex workers were interviewed in each of the brothels using a pre tested questionnaire. Data analysis was done with IBM SPSS statistics version 20. Frequencies percentages and means were generated. Relationship was demonstrated using Chi square at p<0.05

Results: The mean age was 27.77 + 6.16, majority were less than 30years of age (72.0%), single (75.7%), from the southsouth zone of Nigeria (57.0%) and had at least a secondary school education (51.7%). Three quarters of the single FSW had steady sexual partners. A high proportion of the respondents still have misconceptions about routes of transmission and prevention of HIV. About half (53.3%) had good knowledge of HIV/AIDS, 90.0% knew that Ebola Virus Disease can be sexually transmitted and 62.0% had good knowledge of the symptoms of STI. A high proportion reported symptoms of STI (25.0% genital itching, 14.7% genital discharge). Treatment was obtained mostly from the chemist (44.0%) followed by self-medication (42.7%) and health facility (38.7%). Over two thirds have been tested for HIV. All the respondents reported condom use with paying and non-paying casual partners but consistent use was higher with paying partners. A high proportion (77.0%) reported burst condom which was treated by using antibiotics. FSW who were single (p=0.002) and those from the South South-zone of Nigeria (p=0.010) were more likely to be knowledgeable about STI symptoms. Young FSW (<24years) were more likely to use female condoms (p=0.023) and get tested for HIV (p=0.008).

Conclusion: FSW in this study had high burden of STI and poor treatment practices. A high proportion also had poor knowledge of HIV and STI. Health workers did not play a major role in giving information about HIV/HCT and STI or in providing treatment. There is a need to promote referrals, linkages and contact between healthcare workers and this vulnerable group to ensure access to correct information and appropriate treatment.

Keywords: STI, Female Sex Workers, Lagos