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Effects of exposure to an intensive HIV-prevention programme on behavioural changes among female sex workers in Nairobi, Kenya.
Afr J AIDS Res. 2018 Jul; 17(2):99-108.AJ

Abstract

While Kenya has had a long-standing national HIV-prevention programme, evidence on the level of exposure to its interventions and related effects on behavioural changes among female sex workers (FSWs) is limited. Using cross-sectional behavioural data collected in 2013 from 1 357 FSWs aged 18 years and above in Nairobi, Kenya, this study explores the relationship between FSW programme exposure levels and behavioural outcomes including condom use, sexually transmitted infection (STI)-treatment, and empowerment measures like disclosure of self-identity and violence reporting. We categorised programme exposure levels as none, moderate and intensive. Multivariate logistic regression was used for analysis. Overall, 35% of the FSWs were not exposed to any HIV prevention programme, whereas about 24% had moderate and 41% had intensive exposure. FSWs having intensive programme exposure had a higher likelihood of using condoms consistently with occasional clients (AOR: 1.57; 95% CI: 1.08-2.31) and seeking treatment for STIs (AOR: 3.37; 95% CI: 1.63-7.02) compared to FSWs with no or moderate exposure. Intensive programme exposure was also associated with higher self-disclosure of sex-work identity (AOR: 1.63; 95% CI: 1.19-2.24), reporting of violence to police (AOR: 2.45; 95% CI: 1.03-5.84), and negotiation of condom use at last sex when the client was under the influence of alcohol (AOR: 1.63; 95% CI: 0.94-2.82). Although HIV prevention programmes in Kenya have been underway for over a decade, programme efforts were largely focused on saturating the coverage (intervention breadth). Strategies should now focus on ensuring improved quality of contacts through intensified programme exposure (intervention depth) to enhance gains in behavioural change among FSWs and preventing the burden of HIV infection among them.

Authors+Show Affiliations

a Karnataka Health Promotion Trust (KHPT) , Bangalore , India.b Department of Community Health Sciences , University of Manitoba (UoM) , Winnipeg , Canada.b Department of Community Health Sciences , University of Manitoba (UoM) , Winnipeg , Canada.c National AIDS and STI Control Programme (NASCOP), Ministry of Health , Nairobi , Kenya.b Department of Community Health Sciences , University of Manitoba (UoM) , Winnipeg , Canada.b Department of Community Health Sciences , University of Manitoba (UoM) , Winnipeg , Canada.d Partners for Health and Development in Africa (PHDA) , Nairobi , Kenya.c National AIDS and STI Control Programme (NASCOP), Ministry of Health , Nairobi , Kenya.e Ministry of Health (MoH) , Nairobi , Kenya.f The World Bank , Washington DC , USA.f The World Bank , Washington DC , USA.b Department of Community Health Sciences , University of Manitoba (UoM) , Winnipeg , Canada.b Department of Community Health Sciences , University of Manitoba (UoM) , Winnipeg , Canada.b Department of Community Health Sciences , University of Manitoba (UoM) , Winnipeg , Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29514590

Citation

Prakash, Ravi, et al. "Effects of Exposure to an Intensive HIV-prevention Programme On Behavioural Changes Among Female Sex Workers in Nairobi, Kenya." African Journal of AIDS Research : AJAR, vol. 17, no. 2, 2018, pp. 99-108.
Prakash R, Bhattacharjee P, Blanchard A, et al. Effects of exposure to an intensive HIV-prevention programme on behavioural changes among female sex workers in Nairobi, Kenya. Afr J AIDS Res. 2018;17(2):99-108.
Prakash, R., Bhattacharjee, P., Blanchard, A., Musyoki, H., Anthony, J., Kimani, J., Gakii, G., Sirengo, M., Muraguri, N., Mziray, E., Kasonde, L., Blanchard, J., Isac, S., & Moses, S. (2018). Effects of exposure to an intensive HIV-prevention programme on behavioural changes among female sex workers in Nairobi, Kenya. African Journal of AIDS Research : AJAR, 17(2), 99-108. https://doi.org/10.2989/16085906.2017.1377268
Prakash R, et al. Effects of Exposure to an Intensive HIV-prevention Programme On Behavioural Changes Among Female Sex Workers in Nairobi, Kenya. Afr J AIDS Res. 2018;17(2):99-108. PubMed PMID: 29514590.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of exposure to an intensive HIV-prevention programme on behavioural changes among female sex workers in Nairobi, Kenya. AU - Prakash,Ravi, AU - Bhattacharjee,Parinita, AU - Blanchard,Andrea, AU - Musyoki,Helgar, AU - Anthony,John, AU - Kimani,Joshua, AU - Gakii,Gloria, AU - Sirengo,Martin, AU - Muraguri,Nicholas, AU - Mziray,Elizabeth, AU - Kasonde,Lombe, AU - Blanchard,James, AU - Isac,Shajy, AU - Moses,Stephen, Y1 - 2018/03/08/ PY - 2018/3/9/pubmed PY - 2019/5/23/medline PY - 2018/3/9/entrez KW - behaviour change KW - condom use KW - empowerment KW - programme exposure KW - violence SP - 99 EP - 108 JF - African journal of AIDS research : AJAR JO - Afr J AIDS Res VL - 17 IS - 2 N2 - While Kenya has had a long-standing national HIV-prevention programme, evidence on the level of exposure to its interventions and related effects on behavioural changes among female sex workers (FSWs) is limited. Using cross-sectional behavioural data collected in 2013 from 1 357 FSWs aged 18 years and above in Nairobi, Kenya, this study explores the relationship between FSW programme exposure levels and behavioural outcomes including condom use, sexually transmitted infection (STI)-treatment, and empowerment measures like disclosure of self-identity and violence reporting. We categorised programme exposure levels as none, moderate and intensive. Multivariate logistic regression was used for analysis. Overall, 35% of the FSWs were not exposed to any HIV prevention programme, whereas about 24% had moderate and 41% had intensive exposure. FSWs having intensive programme exposure had a higher likelihood of using condoms consistently with occasional clients (AOR: 1.57; 95% CI: 1.08-2.31) and seeking treatment for STIs (AOR: 3.37; 95% CI: 1.63-7.02) compared to FSWs with no or moderate exposure. Intensive programme exposure was also associated with higher self-disclosure of sex-work identity (AOR: 1.63; 95% CI: 1.19-2.24), reporting of violence to police (AOR: 2.45; 95% CI: 1.03-5.84), and negotiation of condom use at last sex when the client was under the influence of alcohol (AOR: 1.63; 95% CI: 0.94-2.82). Although HIV prevention programmes in Kenya have been underway for over a decade, programme efforts were largely focused on saturating the coverage (intervention breadth). Strategies should now focus on ensuring improved quality of contacts through intensified programme exposure (intervention depth) to enhance gains in behavioural change among FSWs and preventing the burden of HIV infection among them. SN - 1727-9445 UR - https://www.unboundmedicine.com/medline/citation/29514590/Effects_of_exposure_to_an_intensive_HIV_prevention_programme_on_behavioural_changes_among_female_sex_workers_in_Nairobi_Kenya_ L2 - http://www.tandfonline.com/doi/full/10.2989/16085906.2017.1377268 DB - PRIME DP - Unbound Medicine ER -