Uptake of HIV Self-Testing and Associated Factors Among Female Sex Workers at Non-Governmental HIV Testing Facilities in Debre Markos and Bahir Dar Towns, Northwest Ethiopia, 2022

Abstract

Background

Human immunodeficiency virus self-testing (HIVST) is universally accepted as an HIV testing option to achieve the United Nations Agency for International Development first 95 goal by 2030. HIV testing coverage through voluntary counseling and testing and provider initiated testing and counseling is low among female sex workers (FSWs). However, there is no evidence on the level of HIVST among FSWs in the study area.

Objective

To assess the uptake of HIVST and associated factors among FSWs at non-governmental facilities in Debre Markos and Bahir Dar towns, Northwest Ethiopia, 2022.

Methods

An institution-based cross-sectional study design was employed. A total of 423 study participants were selected by systematic random sampling technique. The data were collected using a structured and pre-tested questionnaire; entered into EpiData version 3.1 and exported to SPSS version 25 for analysis. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was estimated to assess the strength of association between independent variables and dependent variable. Bivariable logistic regression was done for each variable and those with a P-value of < 0.25% were selected for multivariable analysis. Finally, P-value < 0.05% was declared statistically significant.

Results

The magnitude of HIVST uptake among FSWs was 59.3%. Time since engagement of sex work > 5 years [AOR 2.16 (95% CI: 1.158–4.013)], age of first sexual debut >19 years [AOR 3.23 (95% CI: 2.045–5.093)], previous urban residence [AOR 3.99 (95% CI: 2.58–6.18)], good knowledge towards HIVST [AOR 1.78 (95% CI: 1.066–2.964)], education status being college and above [AOR 5.6 (95% CI: 3.12–9.30)] were significantly associated factors.

Conclusion

HIVST uptake among FSWs was 59.3% which is lower than expected at national level. Educational status, age at first sexual debut, knowledge towards HIVST, and time since engagement in sex work were significantly associated with HIVST uptake.

Keywords:

• HIV self-testing
• female sex worker
• Ethiopia

Abbreviations

ART, Anti-Retroviral Therapy; DC, Data Collector; DIC, Drop in Centre; EDHS, Ethiopian Demographic Health Survey; EPHIA, Ethiopian Population based HIV Impact Assessment; ERC, Ethical Review Committee; FSW, Female Sexual Worker; HCT, HIV Counseling and Testing; HIV, Human Immunodeficiency Virus; HIVST, Human Immunodeficiency Virus Self-Testing; HTS, HIV Testing Service; PrEP, Pre-Exposure Prophylaxis; STI, Sexual Transmitted Infection; UNFPA, United Nations Population Fund survey; UNAIDS, United Nations Agency for International Development; WHO, World Health Organization.

Acknowledgments

The authors would like to thank the study participants and data collectors for making the research possible by participating in the research and their commitment in the process of data collection. Finally the authors would like to express their gratitude to Debre Markos University for providing the opportunity to perform this research.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.