HIV testing and associated factors among female sex workers in Tanzania: approaching the first 90% target?

ABSTRACT

Use of HIV testing services among FSW in sub-Saharan Africa (SSA) is below the desired UNAIDS target of 90%. We estimated the prevalence and factors associated with HIV testing among FSW in Dar es Salaam, Tanzania. A respondent-driven sampling method was used to recruit FSW aged 18. Modified Poisson regression models were used to determine factors associated with recent HIV testing. Of 958 surveyed FSW (median age 26 years), 85.4% (95% CI: 82.3, 88.1) reported to have ever been tested for HIV and 65.3% (95% CI: 61.2, 69.3) tested in the past 12 months. Condom use on the last day worked (prevalence ratio (PR) = 1.17; 95% CI: 0.99, 1.38), no or low self-perceived risk of HIV acquisition (PR = 1.16; 95% CI: 1.02, 1.32), having never felt stigmatized as a sex worker (PR = 1.18; 95% CI: 1.04, 1.33), and having been in contact with a peer educator (PR = 1.33; 95% CI: 1.18, 1.49) during the past year preceding the survey were associated with recent HIV testing. Interventions aiming to mitigate stigma due to sex work, improve health education to address risk perception as a barrier to HIV testing, and scaling up peer educator’s engagement should be given priority.

KEYWORDS:

• HIV
• testing
• female sex workers
• sub-Saharan Africa
• key population

Acknowledgements

We would like to thank all the participants for their time and courage to participating in this research. The authors would also like to thank the research assistants and the data manager who supported the data collection exercise. MM, collected, analyzed the data, interpreted the results, and wrote the first draft of the manuscript, KM, TB, SL, AM, GHL, NM, MTL, AR, and TL, interpreted the results and critically revised the manuscript for important intellectual content. DM and EJM designed the study, collected the data, interpreted the results, and critically revised the manuscript. All authors read and approved the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by DANIDA [grant number 16-P03-TAN]. The first author is partly supported as a postdoctoral fellow by the Fogarty International Center [grant number D43 TW009775].