Peer-reviewed article
Prevalence and predictors of HIV and sexually transmitted infections among vulnerable women engaged in sex work: Findings from the Kyaterekera Project in Southern Uganda
Joshua Kiyingi, Proscovia Nabunya, Ozge Sensoy Bahar, Larissa Jennings Mayo‐Wilson, Yesim Tozan et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined HIV and sexually transmitted infection (STI) prevalence among 542 women engaged in sex work in southern Uganda. The researchers found that 41% were HIV positive and 10.5% had at least one STI. Several factors were associated with higher infection risk, including older age, lower education, drug use, and living in fishing villages or small towns. The findings highlight the need for targeted prevention and economic support programs for this vulnerable population.
Key points
- 41% of women engaged in sex work were HIV positive, compared to estimates three times higher than the general population
- 10.5% tested positive for at least one STI (gonorrhea, chlamydia, or trichomoniasis)
- Older age, lower education levels, and drug use were associated with increased HIV risk
- Location matters: women in fishing villages had higher HIV risk than those in small towns
- Economic factors like financial distress and low financial self-efficacy were associated with increased infection risk
Limitations
This is a cross-sectional baseline study that identifies associations but cannot establish causation. The study provides data on prevalence and predictors but does not evaluate the effectiveness of any intervention.
Abstract
INTRODUCTION: Women engaged in sex work (WESW) have an elevated risk of the human immunodeficiency virus (HIV) and sexually transmitted infections (STI). Estimates are three times higher than the general population. Understanding the predictors of HIV and STI among WESW is crucial in developing more focused HIV and STI prevention interventions among this population. The study examined the prevalence and predictors of HIV and STI among WESW in the Southern part of Uganda. METHODOLOGY: Baseline data from the Kyaterekera study involving 542 WESW (ages 18-55) recruited from 19 HIV hotspots in the greater Masaka region in Uganda was utilized. HIV and STI prevalence was estimated using blood and vaginal fluid samples bioassay. Hierarchical regression models were used to determine the predictors of HIV and STI among WESW. RESULTS: Of the total sample, 41% (n = 220) were found to be HIV positive; and 10.5% (n = 57) tested positive for at least one of the three STI (Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis) regardless of their HIV status. Older age (b = 0.09, 95%CI = 0.06, 0.13, p≤0.001), lower levels of education (b = -0.79, 95%CI = -1.46, -0.11, p≤0.05), fewer numbers of children in the household (b = -0.18, 95%CI = -0.36, -0.01), p≤0.05), location (i.e., fishing village (b = 0.51, 95%CI = 0.16, 0.85, p≤0.01) or small town (b = -0.60, 95%CI = -0.92, -0.28, p≤0.001)), drug use (b = 0.58, 95%CI = 0.076, 1.08, p≤0.05) and financial self-efficacy (b = 0.05, 95%CI = -0.10, 0.00, p≤0.05), were associated with the risk of HIV infections among WESW. Domestic violence attitudes (b = -0.24, 95%CI = -0.42, -0.07, p≤0.01) and financial distress (b = -0.07, 95%CI = -0.14, -0.004, p≤0.05) were associated with the risk of STI infection among WESW. CONCLUSION: Study findings show a high prevalence of HIV among WESW compared to the general women population. Individual and family level, behavioural and economic factors were associated with increased HIV and STI infection among WESW. Therefore, there is a need for WESW focused HIV and STI risk reduction and economic empowerment interventions to reduce these burdens.