posted on 2019-04-23, 11:03authored byAnna Tokar, Iana Sazonova, Sharmistha Mishra, Pavlo Smyrnov, Tetiana Saliuk, Jeffrey V. Lazarus, Jacqueline E.W. Broerse, Maria Roura, James Blanchard, Marissa L. Becker
Objectives Ukraine has one of the largest HIV
epidemics in Europe, with high prevalence among
female sex workers (FSWs). We aimed to identify factors
associated with HIV testing and receipt of the test result
in the last 12 months, HIV prevalence and self-reported
positive status among FSWs in Ukraine.
Methods We used data from an Integrated Bio-
Behavioural Survey among FSWs conducted in 2013–
2014. The survey methodology combined three sampling
strategies: time and location sampling, respondentdriven
sampling and key informant recruitment. We used
multivariable regression to identify factors associated
with self-reported HIV testing in the last 12 months, HIV
prevalence and self-reported positive status among FSWs
living with HIV. Explored factors included: age, age at first
sex, age at entry into sex work, education, marital status,
employment status beside sex work, condom use with
last paying or non-paying sexual partner, drug or alcohol
consumption and sex work venue.
Results R ecent HIV testing was low overall with only
63.2% of FSWs reported having tested and received
their test result in the last 12 months prior to the survey.
HIV prevalence was 7.1% overall, but only 45.0% of
FSWs living with HIV were aware of their HIV status.
Testing in the last 12 months with receipt of test result
was less common among FSWs who used drugs ever in
life (adjusted OR (AOR) 0.7, 95% CI 0.6 to 0.9), women
soliciting clients indoors (AOR 0.8, 95% CI 0.7 to 0.9)
and those not using a condom with last paying sexual
partner (AOR 0.3, 95% CI 0.2 to 0.5). HIV positivity was
associated with history of ever using drugs (AOR 2.3,
95% CI 1.4 to 3.6) and soliciting clients outdoors (AOR
1.5, 95% CI 1.1 to 2.0). Women working indoors were
less aware of their positive status (AOR 0.1, 95% CI 0.1
to 0.9).
Conclusion HIV prevalence is high among FSWs in
Ukraine, and testing and knowledge of one’s status
remain insufficient. HIV testing programmes need to
expand with strategies to reach specific subgroups of
FSWs.
History
Publication
PLoS ONE;95, pp. 193-200
Publisher
Public Library of Science
Note
peer-reviewed
Other Funding information
TransGlobal Health Program, Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria