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Sexual risk behaviors, HIV, and syphilis among female sex workers in Nepal

Authors Kakchapati S, Singh DR, Rawal BB, Lim A

Received 5 October 2016

Accepted for publication 12 December 2016

Published 27 January 2017 Volume 2017:9 Pages 9—18

DOI https://doi.org/10.2147/HIV.S123928

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Professor Bassel Sawaya


Sampurna Kakchapati,1 Dipendra Raman Singh,2 Bir Bahadhur Rawal,2 Apiradee Lim1

1Department of Mathematics and Computer Science, Prince of Songkla University, Pattani, Thailand; 2National Centre for AIDS and STD Control, Kathmandu, Nepal

Purpose: Female sex workers (FSWs) are a key-affected population susceptible to acquiring HIV and sexually transmitted infections (STIs), as well as transmitting the virus to others. The aim of the study was to assess HIV and syphilis prevalence among FSWs in Nepal and to examine factors associated with it.
Materials and methods: The study was based on Integrated Biological and Behavioral Surveillance (IBBS) surveys among FSWs in Nepal from 2004 to 2015. Statistical analysis used chi-squared test to assess statistically significant risk factors for HIV and syphilis. Logistic regression models were used to identify the most important determinants for each outcome.
Results: A total of 5,958 FSWs were tested, and among them, 100 (1.7%) were HIV positive and 230 (3.9%) were syphilis positive. The multivariate analysis revealed that syphilis was higher among those street-based, aged ≥35 years, illiterate, and with a duration of sex work of >3 years. HIV was higher among those aged ≥35 years, illiterate, street-based, and with a duration of sex work >3 years. Syphilis was strongly correlated with HIV.
Conclusion: HIV epidemic among FSWs in Nepal appears in the stagnant trend, whereas STI epidemic has increased in recent years. The high influencing factors for HIV and syphilis prevalence were advanced age, street-based, lower education, and longer duration of sex work. Urgent efforts, as part of routine HIV/STI prevention and intervention, are required to reduce the high burden of syphilis among FSWs.

Keywords: IBBS, sex workers, sexual behaviors, surveillance

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