Regional Differences in HIV Epidemic and HIV testing services usage among Cameroonian female sex worker: Comparing Grand North and Grassland Regions
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Date
2015-05-01
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Johns Hopkins University
Abstract
Introduction Female sex workers (FSW) in Cameroon carry a heightened burden of HIV compared to other women of reproductive age. Previous studies suggested the existence of regional differences in HIV epidemic facilitated by FSW and their sexual partners.
Objective To update HIV prevalence and population characteristics in Cameroonian FSW and to investigate the regional differences in HIV epidemic and HIV services between grand north (Far North, North and Adamawa) and grassland (West and Northwest) in Cameroon.
Method The data were collected through a nation-wide, cross-sectional survey in Cameroon from September to October 2009. Proportional sampling was used to generate the study population across the 10 Cameroonian regions. A total of 994 FSW were eligible and enrolled in the study. HIV and syphilis serology tests were conducted to determine prevalence. Prevalence of HIV in FSW and in general populations of reproductive age across nation were compared. Sociodemographic features, sexual behavior, HIV/STI related knowledge and HIV testing service usage in the FSW population were characterized. Univariate logistic regression and chi-square test were conducted to evaluate differences in HIV prevalence and HIV service usage across regions.
Results The overall proportion of FSW living with HIV was 37.2% (370/994) with a range of 28.4-49.5% across the 10 regions of Cameroon. Grassland regions showed a high HIV prevalence among FSW (38.0-43.3%) and a relatively high HIV prevalence in males of reproductive age (2.9-5.0%) compared to males in other Cameroonian regions. Grand north regions showed a high HIV prevalence among FSW (36.6-49.5%). In contrast there was a relatively low HIV prevalence among males of reproductive age (aged 15-49 years) in the same region (0.8-2.3%) compared to males in other Cameroonian regions. Across regions, most (65.2-95.5%) FSW had been previously tested for HIV, among which 48.3-100% reported having received their test results. Grand north had a higher proportion of FSW with previous HIV test (93.6-95.5%), but a lower proportion of them received the test results (48.3-71.4%). Grassland had a lower proportion of FSW with previous HIV test experience (72.2-80.8%) but a higher proportion of them have receive the result (98.5-100%).
Conclusion FSW in Cameroon had a high prevalence of HIV infection. Prevalence of HIV varied by regions. HIV test and result delivery performance also vary in grand north and grassland. Future HIV program should consider these factors.
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Keywords
HIV, female sex worker, Cameroon