Incidence of HIV infection and associated factors among female sex workers in Côte d'Ivoire, results of the ANRS 12361 PrEP-CI study using recent infection assays

PLoS One. 2022 Nov 17;17(11):e0271988. doi: 10.1371/journal.pone.0271988. eCollection 2022.

Abstract

Background: This study aimed to estimate, using an HIV Recent Infection Testing Algorithm (RITA), the HIV incidence and its associated factors among female sex workers (FSW) in Côte d'Ivoire.

Methods: A cross-sectional study was conducted in 2016-2017 in Abidjan and San Pedro's region among FSW aged ≥ 18 years. In addition, a sociodemographic questionnaire, HIV screening was carried out by two rapid tests. In the event of a positive result, a dried blood spot sample was taken to determine, using a RITA adapted to the Ivorian context, if it was a recent HIV infection.

Results: A total of 1000 FSW were surveyed with a median age of 25 years (interquartile range: 21-29 years). 39 (3.9%) tested positive for HIV. The incidence of HIV was estimated to be 2.3 per 100 person-years, with higher incidence rates among those 24 years old or less (3.0% vs. 1.9%), non-Ivorian FSW (3.2% vs. 1.9%) and those with the lowest education level (4.6% in FSW who never went to school vs. 2.6%). The incidence seemed to be associated with the sex work practice conditions: higher incidence among FSW whose usual price was less than 3.50$ (4.3% vs.1.0%), FSW who had a larger number of clients on the last day of work (6.1% in those with 7 clients or more vs. 1.8%), FSW who reported not always using condoms with their clients (8.5% vs. 1.5%) and FSW who reported agreeing to sex without a condom in exchange for a large sum of money (10.1% vs. 1.2%).

Conclusion: This study confirms that FSW remain highly exposed to HIV infection. Exposure to HIV is also clearly associated with certain sex-work factors and the material conditions of sex work. Efforts in the fight against HIV infection must be intensified to reduce new infections among FSW.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cote d'Ivoire / epidemiology
  • Cross-Sectional Studies
  • Female
  • HIV Infections* / diagnosis
  • HIV Infections* / epidemiology
  • HIV Infections* / prevention & control
  • Humans
  • Incidence
  • Sex Workers*
  • Young Adult

Grants and funding

The PrEP-CI ANRS 12361 was funded by the Bill and Melinda Gates Foundation (Investment ID: OPP1106343) and the French National Agency for AIDS and Viral Hepatitis Research (ANRS). https://www.gatesfoundation.org/ The Bill & Melinda Gates Foundation aims to reduce inequities in health by developing new tools and strategies to reduce the burden of infectious disease.