AEGiS-13IAC: HIV prevalence and risk factors for infection among clients of female sex workers (FSWs) in Abidjan, Cote d'Ivoire.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

HIV prevalence and risk factors for infection among clients of female sex workers (FSWs) in Abidjan, Cote d'Ivoire.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrC675)

Vuylsteke B, Ghys P, Traore M, Konan Y, Mah Bi G, Maurice C, Kakou AR, Sanogo A, Diarra J, Roels TH, Laga M
B. Vuylsteke, Projet Retro - CI, 01 BP 1712, Abidjan 01, Cote D'ivoire, Tel.: +225 212 541 11, Fax: +225 212 429 69, E-mail: bbv1@cdc.gov

INTRODUCTION: From 1992 to 1998, consistent condom use with clients increased from 20% to 79% and HIV prevalence decreased from 90% to 37% among FSWs in Abidjan, where HIV prevalence in the general population was estimated at 14% in 1998. Clients of FSWs are considered an important "bridge population" for targeting prevention efforts, but few data exist on their behavior and risk factors for HIV infection.

OBJECTIVES: To study socio-demographic and behavioral characteristics, and to determine the prevalence of HIV and related risk factors among clients of FSWs in Abidjan.

METHODS: A cross-sectional study was conducted in October 1999. Clients were approached after having had sex with a FSW by trained interviewers at 84 randomly selected sex work-sites in Abidjan. Between 4 and 8 clients were interviewed per site, using a structured questionnaire, and were asked to provide a saliva sample for HIV testing. The saliva samples were tested for HIV antibodies by the GACELISA assay (Murex, Dartford, UK).

RESULTS: A total of 780 male clients were approached and 526 (67%) agreed to participate, of whom 423 (80%) provided a saliva sample. The participants had a the median age of 26 years (range 14-54), 67% were Ivorian, 46% were Muslim, 71% were single, and 48% completed some secondary school. Consistent condom use with FSWs was reported by 93%, and 95% said they used a condom on the past visit, of whom 61% said they proposed to use a condom. A history of STDs in the past year was reported by 19%. HIV prevalence was 13.4%, and was associated with older age, being married or cohabitating, having no other girlfriend, higher monthly income, more FSW visits per month, and being a white collar worker. In multivariate analysis age remained strongly associated with infection.

CONCLUSION: Clients of FSWs do not have a special socio-demographic profile. The high condom use confirms reports of FSWs, and, together with the relatively low HIV prevalence, is most likely a result of prevention efforts for the last 10 years, which should be sustained and reinforced.

Keywords: AEGIS, Prevalence, HIV, Risk Factors, HIV Infections, Condoms, Cross-Sectional Studies, HIV Seropositivity, HIV Antibodies, HIV Seronegativity, Cote d'Ivoire, Human, Female, Male, epidemiology, immunology
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