RESUMEN
BACKGROUND: Female sex workers (FSWs) face a significant and persistent risk of contracting HIV. While evidence indicates high rates of pregnancy among FSWs in sub-Saharan Africa, studies on the coverage of HIV testing during pregnancy among them are sparse. The objective of this study was to estimate the prevalence of prenatal HIV testing and determine the associated factors among FSWs in Nigeria. METHODS: This study was a secondary data analysis of the 2020 Integrated Biological & Behavioural Surveillance Survey (IBBSS) among key populations in Nigeria. We performed weighted descriptive statistics and multivariable binary logistic regression to assess the associations between prenatal HIV testing and sociodemographic characteristics, risk behaviours, HIV knowledge and risk awareness, stigma, and access to healthcare. RESULTS: Of the 1598 FSWs included in the study, 71.0% (95%CI = 68.7%-73.1%) had HIV testing during their last pregnancy. In the regression model, tertiary education (aOR = 2.98, 95%CI = 1.48-6.01), consistent condom use (aOR = 1.95, 95%CI = 1.39-2.75), and receipt of antenatal care (aOR = 35.52, 95%CI = 23.40-53.92) were associated with higher odds of prenatal HIV testing. Compared with the South South geopolitical zone, FSW residing in South East (aOR = 3.38, 95%CI = 1.80-6.35), South West (aOR = 2.97, 95%CI = 1.88-4.68), North Central (aOR = 4.43, 95%CI = 2.80-7.01), North East (aOR = 4.22, 95%CI = 1.64-10.34), North West (aOR = 4.40, 95%CI = 2.59-7.48) had higher odds of reporting prenatal HIV testing. However, being a non-brothel-based FSW (aOR = 0.66, 95%CI = 0.47-0.92), and engaging in sex work during pregnancy (aOR = 0.45, 95%CI = 0.31-0.66) were significantly associated with lower odds of prenatal HIV testing. CONCLUSIONS: The prenatal HIV testing among FSWs in this study was suboptimal. The results highlight the need to improve access to antenatal care and implement regional and typology-specific interventions to bridge the gap in prenatal HIV testing among FSWs.
RESUMEN
Oral pre-exposure prophylaxis (PrEP) is a critical intervention for HIV prevention among key populations (KP) in Nigeria. However, little is known about its coverage among adolescent and young key populations (AYKP). Using the 2020 Integrated Biological & Behavioural Surveillance Survey conducted among KP, including female sex workers (FSW), men who have sex with men (MSM), people who inject drugs (PWID), and transgender people (TG), we assessed the awareness and uptake of PrEP among AYKP (15-24 years) in Nigeria. We performed weighted descriptive statistics and logistic regression analyses. Of the 6882 AYKP included in this study, 36.1% were aware of PrEP, ranging from 47.9% in MSM to 19.8% in FSW. Compared with FSW, MSM (aOR = 3.7, 95%CI = 3.22-4.35) and TG (aOR = 2.6, 95%CI = 2.18-2.98) had significant higher odds of PrEP awareness. Among those aware of PrEP, 24.5% had ever taken PrEP. The uptake of PrEP varied by KP group: TG (28.1%), MSM (25.3%), PWID (18.0%), and FSW (14.4%). MSM (aOR = 2.6, 95%CI = 1.72-4.07) and TG (aOR = 2.7, 95%CI = 1.71-4.14) had significant higher odds of PrEP uptake relative to FSW. The awareness and uptake of PrEP among AYKP in Nigeria is low. This calls for more awareness creation about PrEP addressing the barriers that limit its uptake.
Asunto(s)
Infecciones por VIH , Profilaxis Pre-Exposición , Trabajadores Sexuales , Minorías Sexuales y de Género , Abuso de Sustancias por Vía Intravenosa , Masculino , Humanos , Femenino , Adolescente , Homosexualidad Masculina , Parejas Sexuales , Abuso de Sustancias por Vía Intravenosa/epidemiología , Nigeria/epidemiología , Análisis de Datos Secundarios , Infecciones por VIH/prevención & control , Infecciones por VIH/epidemiologíaRESUMEN
BACKGROUND: Young key populations (YKP) contribute to the burden of HIV in Nigeria and are a priority population for oral pre-exposure prophylaxis (PrEP). However, their uptake of PrEP remains low. We assessed the main barriers to PrEP uptake and the variation among YKP (15-24 years) in Nigeria. METHODS: This study was a secondary data analysis of the 2020 Integrated Biological & Behavioural Surveillance Survey conducted among key populations (KP), including female sex workers (FSW), men who have sex with men (MSM), people who inject drugs (PWID), and transgender people (TG), in 12 states in Nigeria. A closed-ended question asking the main reason for not taking PrEP among KP who had never taken PrEP was included in the surveillance questionnaire. We collapsed the responses into six barrier themes. Using multinomial logistic regression analysis, we examined the association between the barriers (dependent variable) and KP group (independent variable), controlling for age, educational attainment, religion, marital status, employment status, and geopolitical zone. RESULTS: A total of 1776 YKP were included in this study. The most cited barriers by KP group were: lack of access (28.3%) and fear of side effects (28.3%) by FSW; lack of interest (37.1%) by MSM; low risk perception (65.5%) by PWID; and lack of access (34.4%) by TG. The odds of reporting fear of side effects, lack of access, lack of interest, and nonspecific/others reasons were significantly different by KP group. CONCLUSIONS: The barriers limiting the uptake of PrEP among YKP vary by KP group. Our results highlight the need for KP-specific interventions to improve the uptake of PrEP among YKP in Nigeria.