Top

BMC Public Health

Published in:

Open Access 01-12-2015 | Research article

Time to unsafe sexual practice among cross-border female sex workers in Metemma Yohannes, North West Ethiopia

Authors: Lemma Derseh Gezie, Belaynew Wassie Taye, Tadesse Awoke Ayele

Published in: BMC Public Health | Issue 1/2015

Abstract

Background

Because of the nature of their work, female sex workers are at risk of sexually transmitted diseases. Cross-border areas are places where this situation becomes worse. In Ethiopia, there has been a serious scarcity of studies on the time at which unsafe sexual practice starts and on factors which determine the practice among female sex workers there. Therefore, this study aimed to fill this identified gap.

Method

A total of 467 women who had been sex workers at least for three months prior to the resumption of the study were included. A structured and pre-tested questionnaire was used to collect data from July-August, 2010. Descriptive statistics was used to explore the data, and the Extended Cox-Regression model was employed to identify the predictors of time-to-unsafe sexual practice.

Result

The study participants were followed for 6, 643 person-months. The overall incidence density of unsafe sexual practice was 44.71 persons per 1000 persons-months. The hazard of unsafe sexual practice increased by 3.0 % every month (p-value =0.040) due to problem-drinking. Those female sex workers with familiarized clients had a two-fold hazard of practicing unsafe sex compared to their counterparts (AHR = 1.94 95 % CI 1.49, 2.53). The predominant sexual client type and the work place of sex workers were the other significant predictors of unsafe sexual practice.

Conclusions

The incidence of unsafe sexual practice was found to be high among sex workers in the cross-border area. Time-to-unsafe sexual practice was significantly associated with female sex workers’ status of familiarity with their clients, predominant sexual client type, their work place, and the interaction term of time and problem-drinking. Interventions need to be made on these controllable social and behavioral characteristics to help sex workers extend the duration of their safe sexual practice beyond the time they will quit sex work.

Joint United Nations Program on HIV/AIDS (UNAIDS) and World Health Organization (WHO). Global AIDS epidemic: November 2013. UNAIDS, 978-92-9253-032-7.http://www.unaids.org/sites/default/files/media_asset/UNAIDS_Global_Report_2013_en_1.pdf.

Central Statistical Agency [Ethiopia] and ORC Macro. Ethiopian Demographic and Health Survey. 2005: 231–243. Available at: http://www.CSA.gov.et.

Jonathan Crush, Bruce Frayne, Miriam Grant. Linking Migration, HIV/AIDS and Urban food security in Southern and Eastern Africa. 2006:21-23. Available at: http://ebrary.ifpri.org/cdm/ref/collection/p15738coll2/id/125229.

World Health Organization and the Horn of Africa Initiatives. Report on status of Horn of African Border Districts collaboration. Addis Ababa. February 2002. Available at: http://apps.who.int/disasters/repo/8863.pdf.

International Organization for Migration. HIV/AIDS and Population mobility. Available at: http://www.iom.int/jahia/webdav/site/myjahiasite/shared/shared/mainsite/events/docs/2005_AIDS_Population_Mobility.pdf and-population-mobility. Date accessed: March 2010.

Joint United Nations Program on HIV/AIDs. Population mobility and AIDS. February 2001. 92-9173-035-1. Available at: data.unaids.org/Publications/IRC-pub02/jc513-popmob-tu.

Joseph U Becker, Christian Theodosis, and Rick Kulkarni. Journal of the International AIDS Society. Sep 22, 2008. 10.1186/1758-2652-11-3

Bruckner M. Population Size and Civil Conflict Risk; is there a Causal Link. Econ J. 2010;120:535–50.CrossRef

Family Health International. Mapping and census of female sex workers in Addis Ababa, Ethiopia, 2002. Available at: http://www.who.int/hiv/topics/vct/sw_toolkit/mapping_census_female_sex_workers_ethiopia.pdf

10.

Family Health International. Mapping and census of female sex workers in Nazareth, Ethiopia, 2002. Available at: http://www.fhi.org (accessed May 2013)

11.

Lemma D, Belaynew W, Melkie E. Unsafe sexual practice among cross-border commercial sex workers in Mettema Yohannis, northwest Ethiopia. Ethiop J Health Biomed Sci. 2012;1:1.

12.

Varghese B, Maher JE, Peterman TA, Branson BM, Steketee RW. Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use. Sex Transm Dis. 2002;29(1):38–43.CrossRefPubMed

13.

Atalay A, Dereje K, Getnet M. Unprotected sex, sexually transmitted infections and problem drinking among female sex workers in Ethiopia. Ethiop J Health Dev. 2006;20(2):93–8.

14.

Degu G. Knowledge and practice of condom in preventing HIV/AIDS infection among commercial sex workers. Ethiop J Health Dev. 2002;16(3):277–86.

15.

Federal Democratic Republic of Ethiopia, Population Census Commission. Summary and statistical report of the 2007 population and housing census. Addis Ababa, December 2008. http://www.CSA.gov.et.

16.

Lehana Thabane. Sample Size determination. November 19, 2004; Can be accessed from: https://fammedmcmaster.ca/research/files/sample-size-calculations.

17.

Mayfield D, McLeod G, Hall P. The CAGE Questionnaire: Validation of a new alcoholism screening instrument. Am J Psychiatry. 1974;131:1121–3.PubMed

18.

Lagarde E, Carael M, Glynn JR, et al. Educational level is associated with condom use with in non spousal partnership in four cities of sub- Saharan Africa. AIDS. 2001;15:1399–408.CrossRefPubMed

19.

Izugbara CO. Constituting the Unsafe: Nigerian Sex Workers’ Notions of Unsafe Sexual Conduct. Afr Stud Rev. 2007;50(3):29–49.CrossRef

20.

Parrado EA, Flippen CA, McQuiston C. Use of Commercial Sex Workers among Hispanic Migrants in North Carolina: Implications for the Spread of HIV. Perspect Sex Reprod Health. 2004;36(4):150–6.CrossRefPubMed

21.

Georg Heinze. Medical Biostatistics II, section of clinical biometrics. Available at: http://cemsiis.meduniwien.ac.at/fileadmin/msi_akim/CeMSIIS/KB/LV-Unterlagen/Medical_Biostatistics_2.pdf.

22.

Zoran Bursac, C. Heath Gauss, D. Keith Williams, and David Hosmer. Purposeful Selection of Variables. SAS Global Forum 2007, Paper 173–2007. Available at: http://www2.sas.com/proceedings/forum2007/173-2007.pdf.

Title: Time to unsafe sexual practice among cross-border female sex workers in Metemma Yohannes, North West Ethiopia
Authors: Lemma Derseh Gezie
Belaynew Wassie Taye
Tadesse Awoke Ayele
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-015-2035-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Time to unsafe sexual practice among cross-border female sex workers in Metemma Yohannes, North West Ethiopia

Abstract

Background

Method

Result

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Result

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2015

Hepatitis B and C virus infections among patients with end stage renal disease in a low-resourced hemodialysis center in Vietnam: a cross-sectional study

Validation of PIN 3 physical activity survey in low-income overweight and obese young mothers

A qualitative study of Chinese Canadian fathers’ smoking behaviors: intersecting cultures and masculinities

Did HealthKick, a randomised controlled trial primary school nutrition intervention improve dietary quality of children in low-income settings in South Africa?

Physical activity promotion in the primary care setting in pre- and type 2 diabetes - the Sophia step study, an RCT

Reducing diarrhoea deaths in South Africa: costs and effects of scaling up essential interventions to prevent and treat diarrhoea in under-five children