Seroprevalence and Associated Factors of Human Immunodeficiency Virus, Treponema pallidum, Hepatitis B Virus, and Hepatitis C Virus among Female Sex Workers in Dessie City, Northeast Ethiopia

Prevalence of HIV, syphilis, hepatitis B, and hepatitis C in patients attending STI/RTI clinic of a tertiary care teaching hospital

BACKGROUND

Patients attending Sexually transmitted infection/ Reproductive tract infection (STI/RTI) clinics are investigated for HIV and syphilis under the National AIDS Control Program (NACP). Although sexual contact is one of the modes of transmission of hepatitis B and C, they are not investigated under NACP. This study was planned to find the prevalence of HIV, syphilis, hepatitis B, and C in patients attending STI/RTI clinics and to identify the predictive risk factors.

METHODS

A prospective cross-sectional study was carried out over 5 years on 500 consenting adults. 10 ml blood was collected and tests were performed as per standard protocol for HIV, syphilis, hepatitis B, and C. Risk factors for the sexually transmitted diseases were queried.

RESULTS

500 samples were tested, 117(23.4%) men and 383 (76.6%) women. 26(22.2%), 20(17.1%), 11(9.4%) and 01(0.9%) men and 8(2.1%), 36(9.4%), 01(0.3%) and 0(0%) women were positive for HIV, RPR, hepatitis B and C respectively. Dual infection for HIV and syphilis was detected in four (0.8%) men and HIV and hepatitis B in three (0.6%) men.

CONCLUSION

To investigate all patients attending STI/RTI clinics for Hepatitis B and to integrate Hepatitis B testing into the National AIDS Control Program.

Exposure to Treponema pallidum Infection among Adolescent and Young Adult Women in Roraima, Amazon Region of Brazil

BACKGROUND

Syphilis is a chronic infectious disease, and its prevalence has been described since the 15th century. Because of the high prevalence of this infection in Brazil, this study aimed to evaluate the prevalence of syphilis and its associated factors among adolescent and young women living in the city of Boa Vista, Roraima, Brazil.

METHODS

The present study was cross-sectional, descriptive, analytical and quantitative. It involved 200 young and adolescent women. Laboratory tests were performed to diagnose syphilis, and a sociodemographic and epidemiological questionnaire was employed.

RESULTS

In the studied sample, 10 women had a positive result for syphilis, characterizing a prevalence of 5% for infection with Treponema pallidum. There was a statistically significant association between a monthly family income of less than 1 minimum wage and syphilis (p = 0.0449) and between illicit drug use and syphilis (p = 0.0234).

CONCLUSIONS

These results indicate the need for public health interventions, action plans, and the implementation of risk reduction strategies focused on this population.

Determinants of sexually transmitted infections among female sex workers in Ethiopia: a count regression model approach

Background

Sexually transmitted infections (STIs) remain a major public health problem worldwide, with the burden of these infections being high among female sex workers (FSWs), who are often not aware of their infection status. This study aimed to determine the factors that are associated with the number of STIs among FSWs in Ethiopia.

Methods

A cross-sectional bio-behavioral study involving respondent-driven sampling (RDS) was conducted among 6,085 FSWs in 16 towns in Ethiopia. The hurdle Poisson regression model was fitted using STATA Version 16.2. The incident rate ratio and adjusted odds ratio with a 95% confidence interval were employed to show the strength and direction of the association. A p-value of ≤0.05 was used as a threshold for statistical significance.

Results

At least one STI was identified in 1,444 (23.64%) of the FSWs. Age group 35-49 years [IRR = 2.32; 95% CI (1.43, 3.74)], forced first sex [IRR = 1.32; 95% CI (1.01, 1.74)], condom breakage [IRR = 1.32; 95% CI (1.01, 1.74)], and a history of depression [IRR = 1.55; 95% CI (1.12, 2.18)] increase the number of STIs. FSWs aged 25-34 years [AOR = 2.99; % CI (2.54, 3.52)] and 35 = 59 years [AOR = 8.05; % CI (6.54, 9.91)], who were selling sex for 5-10 years [AOR = 1.30; 95% CI (1.1, 1.55)], and above 11 years [AOR = 1.21; 95% CI (1.03, 1.43)] were more likely to get STIs.

Conclusion

STIs are common in Ethiopia. The covariates age, educational status, monthly income, condom failure, age at the first sexual encounter, and long duration of sexual practice are significant predictors of STIs. Health interventions among FSWs need to include awareness generation about the prevention and control of STIs and address the determinants identified in this analysis.

Serological Evidence and Associated Factors of Hepatitis B Virus and Hepatitis C Virus Among Waste Handlers: A Cross-Sectional Study from Northeastern Ethiopia

Background

The World Health Organization (WHO) has identified viral hepatitis, caused by hepatitis B virus (HBV) and hepatitis C virus (HCV), as one of the main global public health issues. People who work in the collection of waste materials, from either household or medical environments, are at greatest risk.

Objective

To determine the prevalence of and factors associated with HBV and HCV among medical and domestic waste handlers in Northeast Ethiopia.

Methods

A comparative cross-sectional study was conducted from January to April 2021 at selected healthcare facilities and municipal settings in Dessie town, Northeast Ethiopia. The sample size was determined using a double population proportion formula, and a simple random sampling technique was employed to select 70 individuals in the medical waste handlers (MWHs) group and 206 in the domestic waste handlers (DWHs) group. Five milliliters of venous blood was collected from each participant and tested for HBV and HCV using an enzyme-linked immunosorbent assay. Data were analyzed using SPSS version 23; the prevalence was computed, Fisher's exact test was used, and logistic regression was applied.

Results

A total of 276 study participants were enrolled and the overall seroprevalence of hepatitis virus was 5.1%. The seroprevalence of HBV infection among MWHs and DWHs was 8.6% and 1.9%, respectively. The overall seroprevalence of HCV infections among MWHs and DWHs was 4.3% and 0.5%, respectively. Medical waste handling, having a history of needle stick injury, and not using personal protective equipment were factors significantly associated with HBV infection.

Conclusion

The overall seroprevalence of viral hepatitis was high. The prevalence of HBV infection among MWHs was in line with the high endemicity classification of the WHO, and there was a significant difference in prevalence between DWHs and MWHs. Both groups of waste handlers should receive proper attention to protect them from HBV and HCV infection.

Prevalence of syphilis and associated factors among female sex workers in Ethiopia: findings from a multilevel analysis of a national bio-behavioral survey

BACKGROUND

Syphilis is a highly contagious sexually transmitted infection posing a significant public health challenge, especially in developing countries, including sub-Saharan Africa. Female sex workers are exposed to sexually transmitted infections, including syphilis, because of their sexual behavior and limited access to health services. However, data on national syphilis prevalence estimates and the associated factors are scarce in Ethiopia. This, as well as our limited knowledge about the extent of clustering among female sex workers in the country, is a critical gap in information we aimed to fill through this analysis.

METHODS

The study was a cross-sectional, bio-behavioral survey conducted among female sex workers in six cities and ten major towns in Ethiopia. Participants were selected using a respondent-driven sampling method. Survey participants provided blood samples for syphilis, HIV, and hepatitis serological testing. Survey data were collected via an interviewer-administered questionnaire. In this analysis, we employed descriptive statistics to summarize data on the study variables. In addition, we used multilevel bivariable and multivariable logistic regression models to examine the association between independent variables and the dependent variable (syphilis prevalence) while accounting for the clustering effect.

RESULT

A total of 6085 female sex workers participated in the survey. Their median age [Interquartile Range (IQR) was 25 (8)] years, and a majority (96.1%) were in the 20-24-year-old age group. The prevalence of syphilis among female sex workers in Ethiopia's six cities and ten major towns was 6.2%. Being in the age group of 30-34 (AOR = 2.64; 95% CI = 1.40, 4.98) and 35-59 (AOR = 4.7; 95% CI = 2.5, 8.86), being divorced/widowed (AOR = 1.37; 95% CI = 1.03, 1.82), having no formal education (AOR = 3.38; 95% CI = 2.34, 5.11), primary 1st cycle (grades 1-4) education (AOR = 2.77; 95% CI = 1.79, 4.30), and having primary 2nd cycle (grades 5-8) education (AOR = 1.80; 95% CI = 1.21, 2.69) were significantly associated with syphilis among female sex workers.

CONCLUSION

The prevalence of syphilis among female sex workers was high. Being divorced/widowed or in the older age group and having a low level of education were significantly associated with an increased risk of syphilis. The high prevalence and associated factors identified need to be considered in planning comprehensive interventions to control syphilis among female sex workers in Ethiopia.

Sero-prevalence and associated factors of sexually transmitted infections among youth-friendly services Attendees

BACKGROUND

Worldwide, more than one million peoples acquire sexually transmitted infections (STIs). The burden of STIs and the youth awareness level on the transmission of STIs is under investigated in Sidama Regional State.

OBJECTIVE

To determine the seroprevalence of STIs such as hepatitis B surface antigen (HBsAg), Anti-hepatitis C virus (HCV) antibodies, Human Immunodeficiency virus (HIV) seroprevalence, and syphilis and to determine associated factors among youth-friendly services Attendees at selected health facilities in Hawassa city, Ethiopia.

METHODS

A multicenter cross-sectional study was conducted among 416 randomly selected youth attending youth-friendly services at selected health facilities from May to August 2021. To collect the background characteristics of participants an interviewer-administered questionnaire was used. Blood samples were collected, processed, and tested using Advanced Quality One Step rapid colloidal gold immunochromatographic assay for detection of antibodies for syphilis and hepatitis C virus infection, and hepatitis B virus surface antigen. For the diagnosis of syphilis Rapid Plasma Reagin was also used. HIV1/2 STAT PAK, HIV1/2/O ABON and HIV1/2 SD Bioline were used for testing antibodies for HIV infection. Data entry and analysis were performed using Statistical Package for the Social Sciences (SPSS) version 20.0 software. A crude and adjusted odds ratio with a 95% confidence interval (CI) was computed to identify associated factors.

RESULTS

The overall seroprevalence of STIs was 11.5% (48/422), with a 95% CI: (8.7-14.9). Out of the 48 positive results, the proportions of HBsAg, Anti-HCV, HIV, and syphilis were 56.3% (27/48), 27.1% (13/48), 10.4% (5/48), and 6.3% (3/48) respectively. Out of 416 participants, 17.1% responded that it is safe to have sex without using a condom. The Odds of developing STI among female participants, participants who did not identify alcohol intake as a risk factor for STIs, and those who engaged in transactional sex were (AOR = 2.989: 95% CI: 1.27, 7.02), and (AOR = 2.393, 95% CI: 1.18, 4.81) and practice of transactional sex (AOR = 5.527, 95% CI: 1.62, 18.75).

CONCLUSIONS

STIs are common among youth-friendly services Attendee in Hawassa city The overall STI was significantly associated with sex (females), not able to identify alcohol intake as a risk factor, and practice of transactional sex. High number of (n = 289, 69.5%) participants think that the use of condoms is not effective in preventing STIs and they engage in sexual activity without using condoms.

Prevalence and factors associated with hepatitis B and C virus infections among female Sex workers in Ethiopia: Results of the national biobehavioral Survey, 2020

BACKGROUND

Hepatitis B and C virus infections are endemic diseases in sub-Saharan Africa, the region with the highest prevalence of these infections in the world. Female sex workers are exposed to sexually transmitted infections, including hepatitis B and C, because of their high-risk sexual behavior and limited access to health services. There are no large-scale data on the prevalence of hepatitis B and C virus infections among female sex workers in Ethiopia, a critical gap in information this study aimed to fill.

METHODS

This was a cross-sectional, biobehavioral survey conducted from December 2019-April 2020 among 6085 female sex workers aged ≥15 years and residing in sixteen (16) regional capital cities and selected major towns of Ethiopia. Blood samples were collected from the participants for hepatitis B and C virus serological testing. The data were collected using an open data kits (ODK) software and imported into STATA version16 for analysis. Descriptive statistics (frequencies and proportions) were used to summarize data on the study variables. Bivariable and multivariable logistic regression analyses were conducted to determine the strength of association between independent variables (risk factors) and the outcome (hepatitis B and C virus infection). Adjusted Odd ratio (AOR) was used to determine independent associations, 95% confidence interval to assess precision of the estimates, and a P value ≤ 0.05 to determine statistically significant.

RESULTS

The prevalence of hepatitis B and C infections among the 6085 female sex workers was 2.6% [(95% CI (2.2,2.8)] and 0.5% [(95% CI (0.4,0.7)], respectively. Female sex workers who had 61-90 and ≥91 paying clients in the past six months [(AOR = 1.66; 95% CI, (0.99, 2.79); P = 0.054] and [(AOR = 1.66 95% CI, (1.11, 2.49); P = 0.013], respectively, age at first sex selling of 20-24 and >25 years [(AOR = 1.67; 95% CI, (1.14, 2.44); P = 0.009)] and [(AOR = 1.56; 95% CI (1.004, 2.43); P = 0.048)], respectively, known HIV positive status [(AOR = 1.64; 95% CI (1.03, 2.62); P = 0.036] were significantly associated with the prevalence of hepatitis B virus infection. Similarly, hepatitis C was significantly associated with, age at first sex ≤15 years and age 16-20 years [(AOR = 0.21; 95%CI (0.07,0.61); P = 0.005)] and [(AOR = 0.18; 95% CI (0.061, 0.53); P = 0.002)], respectively, known HIV positive status [(AOR = 2.85; 95%CI (1.10,7.37); P = 0.031)] and testing positive for syphilis [(AOR = 4.38; 95% CI (1.73,11.11); P = 0.002)], respectively.

CONCLUSION

This analysis reveals an intermediate prevalence of hepatitis B and a low prevalence of hepatitis C infection among female sex workers in Ethiopia. It also suggests that population groups like female sex workers are highly vulnerable to hepatitis B, hepatitis C, and other sexually transmitted infections. There is a need for strengthening treatment and prevention interventions, including immunization services for hepatitis B vaccination, increasing HCV testing, and provision of treatment services.

Magnitude and Determinants of Syphilis and HIV Co-Infection Among Female Sex Workers in Ethiopia: Evidence from Respondent Driven Samples, 2019-2020

Background

Female sex workers (FSWs) play an important role in transmitting Human Immunodeficiency Virus (HIV) and syphilis from high-risk groups to the general population. Syphilis and HIV infections are generally more prevalent among FSWs. However, in Ethiopia, up-to-date evidence about Syphilis-HIV co-infections among FSWs was lacking.

Objective

To determine the magnitude and determinants of Syphilis-HIV co-infection among FSWs in Ethiopia, 2019-2020.

Methods

A cross-sectional HIV and other sexually transmitted infections Bio-Behavioral Survey (HSBS) was conducted using respondent-driven sampling (RDS) among 6,085 FSWs in Ethiopia from August 2019 to January 2020. Data was collected, merged with laboratory data, and analyzed in R software using the RDS package. The odds ratio was calculated at 95% CI to measure associations between the dependent and independent variables. Variables that yield p<0.25 in univariate analysis were included in multivariate analysis. In multivariate analysis, variables with p<0.05 were declared as statistically significant. Results were presented in frequency tables and charts.

Results

The prevalence of Syphilis-HIV co-infection among FSWs was 2.9% [95% CI=2.6-3.2]. Age of the FSWs (15-19 years old (AOR=0.03; 95% CI=0.01-0.12)), non-formal educational level (AOR=3.18; 95% CI=1.78-5.68), monthly income <2,500 ETB (AOR=3.05; 95% CI=1.45-6.42), major depression (AOR=1.85; 95% CI=1.18-2.89), forced first sex experience (AOR=1.71; 95% CI=1.2-2.44), condom breakage (AOR=1.62; 95% CI=1.14-2.30), Hepatitis B seropositivity (AOR=2.32; 95% CI=1.10-4.90), and Hepatitis C seropositivity (AOR=5.37; 95% CI=1.70-16.93) were strongly associated with Syphilis-HIV co-infection among FSWs in Ethiopia.

Conclusion

The prevalence of Syphilis-HIV co-infection among FSWs in Ethiopia was high. To ward off Syphilis-HIV co-infection among FSWs, a special FSWs-targeted HIV and Syphilis/STIs prevention program and treatment approach needs to be devised. An outreach approach to address the sexual and reproductive health needs of FSWs has to be part of the strategy.

Seroprevalence of Hepatitis B Virus, Hepatitis C Virus, Syphilis and Associated Factors Among Female Sex Workers in Gondar Town, Northwest Ethiopia

Background

Sexually transmitted infections (STIs) are a public health problem worldwide. Hepatitis B virus infection (HBV), hepatitis C virus infection (HCV), and syphilis are among the STIs. Female sex workers (FSWs) continue to be a high-risk group for STIs due to a variety of factors, including exposure to unsafe sexual practices. Therefore, this study determines the seroprevalence of HBV, HCV, Treponema palladium, and associated factors among FSWs in Gondar town, Northwest Ethiopia.

Methods

A cross-sectional study was conducted on 194 FSWs from March to June 2021 in Gondar town. Socio-demographic and behavioral data were collected using a questionnaire. Five milliliters (5mL) of venous blood was collected and tested for hepatitis B surface antigens, anti-hepatitis C antibodies, and anti-syphilis antibodies using an enzyme-linked immunosorbent assay. Logistic regression, univariate, and multivariate analyses were carried out. A p-value of < 0.05 at a 95% confidence interval was considered statistically significant.

Results

A total of 194 FSWs were included in the study. The seroprevalence rates of HBV infection, HCV infection, and syphilis were 23 (11.9%), 13 (6.7%), and 22 (11.3%), respectively. All three infections were statistically associated with inconsistent condom use (AOR = 1.72, 95% CI: 1.95-5.07, p = 0.03); (AOR = 10.51, 95% CI: 1.62-68.26, p = 0.014); and (AOR = 17.3, 95% CI: 4.55-65.6, p = 0.001). Whereas sex stimulant drug use (AOR = 9.4, 95% CI: 1.002-88.14), intravenous drug use (AOR = 15.53, 95% CI: 1.9-127.99, p=0.011), and sex while having a vaginal ulcer (AOR = 5.72, 95% CI: 1.13-28.9, p=0.035) were all statistically associated with HCV infection.

Conclusion

The prevalence of HBV infection, HCV infection, and syphilis was comparatively higher. Regular screening, health education, and other preventative strategies are advised to lower the STI burden among FSWs.

Prevalence of Hepatitis B Virus infection and associated factors among female sex workers using respondent-driven sampling in Hawassa City, Southern Ethiopia

Background

Female sex workers (FSWs) are a marginalized group notoriously having limited healthcare access and poor-quality care. Inevitably, they are vulnerable to sexually transmitted infections including hepatitis B virus. However; Hepatitis B virus infection is one of the most serious infections and major public health problem considered to be at soaring risk for transmission and acquisition of the infection. Hence, this study was aimed to assess the prevalence and associated factors of HBV infections among FSWs in southern Ethiopia.

Methods

A cross-sectional study was conducted from November to February 2019 at Hawassa city in ISHDO confidential clinic among 383 FSWs. Respondent-driven consecutive sampling was used to select study participants using a standardized questionnaire. Blood sample was collected and viral surface antigen was detected using ELISA from separated serum. Data were entered to SPSS version 21.0. Descriptive and logistic regression analyses were used.

Result

The overall prevalence of FSWs who were tested for HBV using ELISA was 35(9.2%) (95% CI: 6.3–12.1). Among 381 FSWs 249(65.4%) were stayed for 2–5 years in sexual work and 240(63%) of them were used condom consistently during sexual practice. In multivariate logistic regression analysis, FSWs who didn’t use condom were six and two times more risk full to acquire HBV than those who used condom commonly (AOR = 6.38, CI 2.04–18.51) and condom breakage (AOR = 2.10, CI 1.95–4.65), during sexual practice respectively. Similarly, use of stimulants (AOR = 3.25, CI 1.59–18.63), previous history of STI (AOR = 2.15, CI 1.02–6.93), genital ulcer (AOR = 4.64, CI 1.31–11.35), number of sexual partners (AOR = 3.25, CI 1.59–7.47), sex during menses (AOR = 5.85, CI (1.29–21.44), sexual assault (AOR = 2.93, CI 1.23–9.01), sharp material sharing, (AOR = 4.98, CI 1.34–10.95) and history of abortion, (AOR = 2.46, CI 1.18, 12.19), were statistically associated with HBV infection. Factors such as age, residence, and alcohol consumption were not associated with HBV infection.

Conclusion

The prevalence of HBV infection in this study was relatively high compared to the general population. Factors like sociodemographic, behavioral, and previous history-related information were associated with HBV infection shows the need for ongoing screening of high-risk population to inform planning for vaccination and preventive measures.

Seroprevalence of Hepatitis B Virus and Associated Factors Among Female Sex Workers Using Respondent-Driven Sampling in Hawassa City, Ethiopia

BACKGROUND

Female sex workers (FSWs) are a marginalized group having limited healthcare access and poor-quality care. Inevitably, they are vulnerable to sexually transmitted infections including hepatitis B virus. It is one of the most serious and major public health problems, with an increased risk of transmission and acquisition of the infection. Hence, this study was aimed to assess the prevalence and associated factors of HBV infection among FSWs in southern Ethiopia.

METHODS

A cross-sectional study was conducted from November to February 2019 at Hawassa city among ISHDO confidential clinics among 383 FSWs using respondent-driven consecutive sampling techniques to select study participants using a standardized questionnaire. The blood samples were collected to detect viral surface antigen using ELISA. Data were entered into SPSS version 21. Descriptive and logistic regression analysis was used.

RESULTS

The overall prevalence of HBV was 35 (9.2%) (95% CI=6.3-12.1). Among 381 FSWs, 249 (65.4%) of them had stayed for 2-5 years in sexual work. A total of 240 (63%) of them used condoms consistently during sexual practice. In multivariate analysis, FSWs who did not use a condom during sexual practice were 6-times more at risk than those who used a condom (AOR=6.38, CI=2.04-18.51). Condom breakage (AOR=2.10, CI=1.95-4.65), use of stimulants (AOR=3.25, CI=1.59-18.63), history of STI (AOR=2.15, CI=1.02-6.93), and genital ulcer (AOR=4.64, CI=1.31-11.35), number of sexual partners (AOR=3.25, CI=1.59-7.47), sex during menses (AOR=5.85, CI=1.29-21.44), sexual assault (AOR=2.93, CI=1.23-9.01), sharp material sharing (AOR=4.98, CI=1.34-10.95), and history of abortion (AOR=2.46, CI=1.18-12.19) were statistically associated with HBV infection.

CONCLUSION

The prevalence of HBV infection in this study was relatively high compared to the general population. Factors like sociodemographic, behavioral, and previous information were associated with HBV infection. There is a need for ongoing screening of this high-risk population to inform planning for vaccination and preventive measures.