Barcelona 2013
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| Abstract #528 - E-Posters English | ||||
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Session: 50.31: E-Posters English (Poster) on Sunday in Chaired by Authors: Presenting Author: Prof. Sónia Dias - Instituto de Higiene e Medicina Tropical/Universidade Nova de Lisboa, Portugal |
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| Additional Authors: Dr. Jordi Casabona, Sra Cristina Sanclemente, Dra. Anna Esteve, Dra. Victoria Gonzalez, Grupo HIVITS TS, | ||||
| Aim: Sex workers (SW) are one of the groups most-at-risk of HIV infection and transmission. However, HIV behavioral data among SW is limited and researching such hidden populations, who are frequently marginalized, is challenging. Developing participatory health research with hard-to-reach populations has been increasing. This participatory study was developed to characterize HIV sexual risk behaviors and obtain information on HIV infection among SW. | ||||
| Method / Issue: A KAP cross-sectional study was conducted with SW in Portugal. A participatory approach was used, in which all study partners (from policy-making, health services, academia, NGOs and community) participated actively in designing the study, implementing the field work and interpreting the results. A total sample of 1040 SW was enrolled. Data were collected by trained interviewers in sex work venues and community-based organizations. A structured questionnaire was used for collecting data on sociodemographic characteristics, sexual behaviors, HIV testing and self-reported HIV infection. After the questionnaire, an HIV rapid test was offered; 213 SW accepted. Descriptive analysis of data was performed. Chi-square test was used to compare proportions. | ||||
| Results / Comments: The participatory process contributed to a more appropriate study design, methodology, methods and measures for the SW population and setting. Involving community partners in the questionnaire elaboration helped to reduce misinterpretation of questions because concepts and measures were contextually congruent. The participatory approach throughout the data collection process (by having NGOs and SW community actively participating in the study implementation) contributed to enhance participants? acceptance of the study and recruitment rates. Some challenges throughout this process were ascertaining how best to reach SW hidden subgroups and assuring scientific rigor, and also addressing ethical issues raised by using interviewer-applied questionnaire, concerning confidentiality and honesty of responses. In total, a large and diverse sample was obtained: 82% females, 10.2% males and 7.8% transgenders; mean age 35.1 ± 10.5 years; 56.3% Portuguese; 53.8% outdoor SW. About 60% of respondents had up to three client sexual partners in their last working day. Inconsistent condom use with clients was reported by 11.5% of respondents while inconsistent condom use with non-client partners was reported by 67.9%. Also, 59.7% didn?t use condom with their last non-client sexual partner. The overall proportion of condom breakage in the last six months was 45.6%. About 10% had forced sexual relations. Of the total sample, 36.2% had used psychoactive substances. Among those, 16.2% used injecting drugs. Overall, 90.2% had been tested for HIV. Of the respondents ever tested, 7.2% reported being HIV positive and 10.1% didn?t know their serostatus for HIV. | ||||
| Discussion: Despite being a complex, challenging and lengthy process, adopting a participatory approach turned to be an effective way to obtain evidence on HIV behavioral patterns of SW populations and identify relevant intervention priorities. | ||||
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