DEMOGRAPHIC AND BEHAVIOURAL FACTORS INFLUENCING THE UPTAKE OF VOLUNTARY COUNSELLING AND TESTING AMONG FEMALE SEX WORKERS: A SECONDARY DATA ANALYSIS OF 2007 IBBSS

Abstract

Despite vigorous promotion, the uptake of Voluntary Counselling and Testing (VCT) has been low overall in sub-Saharan Africa, Nigeria inclusive. The large majority of HIV-1 infected people in sub-Saharan Africa are not aware of their HIV status. Population subgroups such as female sex workers (FSW) are at increased risk of contracting HIV due to their high risk sexual and other behaviours. This group remains under diagnosed despite their level of HIV risk and also they do not patronize VCT services. Hence the need to identify those demographic and behavioural factors which may serve as determinants of VCT uptake among FSWs. The study was a secondary data analysis of HIV testing among the FSW arm of the IBBSS 2007, a cross sectional survey of high risk groups for HIV in six states in Nigeria. The study included 2889 female sex workers. Data was analysed using SPSS version 15.0. Univariate analysis was employed to calculate frequencies and distributions of each variable.Chi-square test was used for bivariate analyses to determine the significance of the association between categorical variables and sexual and behavioural risk factors and VCT uptake. Logistic regression analysis was performed to identify the factors associated with the outcome variable. A p-value <0.05 was considered to indicate statistical significance. The mean age of the sex workers was 26.1 years (SD 5.8 years) and ranged between 15-49 years. The mean ages were similar between brothel based (26.6 years SD 6.1 years)and non-brothel based sex workers (25.5 years SD 5.4 years). Prevalence of VCT among female sex workers was 43.0%. After adjusting for other variables, those with another income source were about twice likely to have received VCT compared to those without another income source (OR=1.526, 95%CI=1.180-1.975). Brothel based sex workers are about three times more likely than non-brothel based sex workers to receive VCT (OR=2.314,95% CI=1.780-3.007). Female sex workers who had knowledge of a facility to receive VCT were twice likely to have had VCT compared to those who did not (OR=1.978, 95%CI=1.580-2.476). Also, female sex workers who had knowledge of the price of VCT were about nine times more likely than those without the knowledge of the price of VCT to have had a VCT (OR=S.230, 95%CI=5.195-13.036). The study shows that the factors influencing the uptake of VCT vary between female sex workers. HlV testing services should be made readily available to FSW with more attention paid to non-brothel based FSWs Who are less likely to have had a HIV test. Innovative methods of reaching this special group and improving VCT need to be developed.