Factors associated with knowledge and use of hiv prevention strategies among female sex workers in 12 brazilian cities

Kolling, Ana Francisca; Oliveira, Silvano Barbosa de; Merchan-Hamann, Edgar

doi:10.1590/1413-81232021268.17502020

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ARTICLE • Ciênc. saúde coletiva 26 (08) • Aug 2021 • https://doi.org/10.1590/1413-81232021268.17502020 copy

Factors associated with knowledge and use of hiv prevention strategies among female sex workers in 12 brazilian cities

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This article aims to Identify factors associated with knowledge and use of combined HIV prevention strategies among female sex workers (FSW). Cross-sectional epidemiological study, using the Respondent Driven Sampling (RDS) method. Descriptive analyzes were performed after adjustments required by the RDS method. To investigate factors associated with knowledge of PEP and PrEP and use of the female condom, Poisson regression was applied, using odds ratio as an association measure. FSW not affiliated with NGOs, who did not receive informational material on prevention and / or participated in lectures in the last six months and who do not identify themselves as FSW in healthcare service facilities have less knowledge about PEP and PrEP and use the female condom less frequently. In general, FSW do not have sufficient knowledge and access to combined HIV prevention methods to take advantage of their benefits. We believe that the adoption of different models of care for FSW in partnership with NGOs can be an effective strategy for expanding knowledge and use of HIV prevention methods in Brazil.

Key words:
HIV; Sex work; Prevention

Acess	n	%	CI
Male condom
Yes	3,449	81.9	80.2 - 83.4
No	764	18.1	16.6 - 19.8
Female condom
Yes	1,407	33.5	31.6 - 35.5
No	2,790	66.5	64.5 - 68.4
Lubricating gel/cream
Yes	1,697	40.3	38.4 - 42.3
No	2,509	59.7	57.7 - 61.6
Use	n	%	CI
Female condom
Yes, frequently	262	6.2	5.3 - 7.3
Yes, occasionally	1,039	24.7	23.1 - 26.4
No, never	2,900	69	67.2 - 70.8
Hepatitis b vaccine	n	%	IC
No	1,568	37.4	35.6 - 39.3
Yes (1, 2 or 3 doses)	1,319	31.5	29.7 - 33.3
Yes. But i can’t remember the nº of doses	612	14.6	13.2 - 16.1
I don’t know	691	16.5	15.1 - 18.0
Hiv treatment	n	%	CI
Yes. I do	64	71.3	57.7 - 80.3
I did. But i stopped	4	4.1	1.5 - 10.8
No	22	24.6	14.9 - 36.7
Syphilis treatment	n	%	CI
Yes	423	87.8	83.8 - 90.9
No	59	12.2	9.1 - 16.2
PEP	n	%	CI
Yes	131	7.1	5.7 - 8.8
No	1,729	92.9	91.2 - 94.3

Where did you receive female condoms for free?	n	%	CI
At a public healthcare service	904	64.2	60.9 - 67.3
At an NGO or other organization	159	11.3	9.3	- 13.7
Where I work as a sex worker	271	19.2	16.8 - 22.0
At a bar, club, bathhouse or saunas	11	0.8	0.4	- 1.4
I got it from a prevention worker	204	14.5	12.2 - 17.1
Where did you attend a lecture or receive educational material?
At a public health service	522	50.8	47.0 - 54.6
At an NGO or other organization	177	17.3	14.5 - 20.3
Where I work as a sex worker	174	17	14.5 - 19.7
Somewhere else	176	17.2	14.5 - 20.4
In the past 12 months, did you have any problem related to sexually transmitted diseases? Which service did you seek first?
Drugstore	254	18.2	15.8 - 21.0
Free clinic or family health clinic	714	51.3	47.8 - 54.6
SAE, Specialist Center, public clinic or PAM	27	1.9	1.1	- 3.3
UPA or another public healthcare facility	36	2.6	1.7	- 4.0
Public hospital clinic	29	2.1	1.3	- 3.2
Private practice	80	5.8	4.4	- 7.5
Private emergency	7	0.5	0.2	- 1.3
A physician or healthcare professional at my workplace	6	0.4	0.1	- 1.3
No service whatsoever	240	17.2	14.0 - 19.9
Have you received any type of assistance because of physical or verbal violence?
Yes	187	22.6	19.2 - 26.5
No	638	77.4	73.5 - 80.8
Have you sought any type of assistance due to sexual violence?
Yes	288	26.5	23.3 - 30.0
No	797	73.5	70.0 - 76.7
When you visit a healthcare provider, do you say you are a sex worker?
Yes, always	1.014	24.3	22.7 - 25.9
Sometimes	626	15	13.6 - 16.4
Usually no	386	9.2	8.1	- 10.5
I never identify myself as a sex worker	2.153	51.5	49.6 - 53.5

Factors	Knowledge of PEP				Knowledge of PrEP
	Bivariate		Multivariate		Bivariate		Multivariate
	PR	CI 95%	PR	CI 95%	PR	CI 95%	PR	CI 95%
Education
Incomplete primary - incomplete junior high	1.000		1.000		1.000		-	-
Incomplete junior high - incomplete and complete higher ed.	1.571	1.32 - 1.87	1.492	1.25 - 1.79	1.186	0.92 - 1.52	-	-
Workplace
Street	1.000		1.000		1.000		-	-
Private place	1.457	1.21 - 1.75	1.275	1.05 - 1.55	1.041	0.80 - 1.35	-	-
Have you joined or become a member of an NGO?
Yes	1.000		1.000		1.000		1.000
No	0.506	0.38 - 0.67	0.609	0.45 - 0.83	0.426	0.30 - 0.59	0.493	0.35 - 0.69
Have you attended any lecture and/or received educational material on STIs/AIDS in the past six months?
Yes	1.000		1.000		1.000		1.000
No	0.603	0.50 - 0.73	0.679	0.56 - 0.83	0.569	0.44 - 0.74	0.654	0.50 - 0.85
Do you usually go to the same healthcare provider?
Yes	1.000		1.000		1.000		-	-
No	0.719	0.59 - 0.88	0.742	0.60 - 0.92	0.945	0.71 - 1.26	-	-
Do you identify yourself as a sex worker to your healthcare provider?
Yes*	1.000		1.000		1.000		1.000
No*	0.739	0.61 - 0.90	0.747	0.61 - 0.91	0.537	0.41 - 0.69	0.569	0.44 - 0.74

Factors	Female condom use
	Bivariate		Multivariate
	PR	CI 95%	PR	CI 95%
Workplace
Street	1.000		1
Private place	0.758	0.63 - 0.91	0.7780462	0.61 - 0.99
Period of exposure in the profession
<5 years	1.000		1
5 years or more	1.346	1.11 - 1.62	1.313703	1.02 - 1.70
Have you joined or become a member of an NGO?
Yes	1.000		1
No	0.509	0.38 - 0.67	0.5768557	0.40 - 0.83
Have you attended any lecture and/or received educational material on STIs/AIDS in the past six months?
Yes	1.000		1.000
No	0.713	0.59 - 0.86	0.734	0.57 - 0.94
In the past 6 months, how frequently did you use a condom
during vaginal sex with one (or more) stable partner(s)?
Never	1.000		1.000
Less than half the time	1.211	0.84 - 1.74	1.356	0.93 - 1.98
More than half the time	2.438	1.63 - 3.64	2.396	1.57 - 3.65
Always	1.777	1.38 - 2.28	1.744	1.35 - 2.25
Do you identify yourself as a sex worker to your healthcare provider?
Yes	1.000		1.000
No	0.579	0.48 - 0.70	0.541	0.42 - 0.70

ABRASCO - Associação Brasileira de Saúde Coletiva Av. Brasil, 4036 - sala 700 Manguinhos, 21040-361 Rio de Janeiro RJ - Brazil, Tel.: +55 21 3882-9153 / 3882-9151 - Rio de Janeiro - RJ - Brazil
E-mail: cienciasaudecoletiva@fiocruz.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Collaborations

The authors have significantly contributed to the article and agree with the content of the manuscript. AF Kolling and E Merchan-Hamann participated in the study conceptualization and design, data analysis and interpretation, writing of the article, and approval of the final version. SB Oliveira participated in statistical analysis, data interpretation, revision of the manuscript, and approval of the final version.