Psychosocial correlates of regular syphilis and HIV screening practices among female sex workers in Uganda: a cross-sectional survey

• Published in: AIDS research and therapy 2019-09, Vol.16 (1), p.28-9, Article 28
• Main Authors: Muhindo, Richard, Castelnuovo, Barbara, Mujugira, Andrew, Parkes-Ratanshi, Rosalind, Sewankambo, Nelson K, Kiguli, Juliet, Tumwesigye, Nazarius Mbona, Nakku-Joloba, Edith
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Attitudes; Confidence intervals; Correlates; Correlation analysis; Cross-Sectional Studies; Cytokines; Demographics; Demography; Diagnosis; Disease transmission; Effectiveness; Female; Female sex workers; Health aspects; HIV; HIV infections; HIV Infections - diagnosis; HIV Infections - epidemiology; HIV Infections - psychology; HIV tests; Human immunodeficiency virus; Humans; Mass Screening - psychology; Mass Screening - statistics & numerical data; Medical tests; Middle Aged; Norms; Prevalence; Prostitutes; Prostitution; Public relations; Regular syphilis and HIV screening; Risk Factors; Screening; Serological tests; Sex; Sex industry; Sex oriented businesses; Sex Workers - psychology; Sexually transmitted diseases; Sexually Transmitted Diseases - diagnosis; Sexually Transmitted Diseases - psychology; Social aspects; Statistical analysis; STD; Syphilis; Syphilis - diagnosis; Syphilis - epidemiology; Syphilis - psychology; Uganda; Uganda - epidemiology; Women; Workers; Working women; Young Adult
• ISSN: 1742-6405; 1742-6405
• DOI: 10.1186/s12981-019-0244-0

Limited data are available regarding correlates of regular sexually transmitted infections (STIs) and HIV screening among female sex workers (FSW) in Sub-Saharan Africa. In this study, we aimed to assess the frequency of regular syphilis and HIV screening and the psychosocial correlates associated with screening among FSW in Uganda. This cross-sectional correlational study was conducted among 441 FSW, aged 17-49 years. We enrolled FSW through peer referrals and ascertained self-reported data on number of serological tests for HIV, syphilis and other STIs in the prior 12 months using an interviewer-administered questionnaire. In addition, we assessed attitudes, norms, social influences and self-efficacy towards 3-monthly Syphilis and 6-monthly HIV testing. We estimated the correlates of regular STI and HIV testing using negative binomial regression. Of the respondents 420 (95.2%) reported to have ever taken an HIV test with 297 (67.4%) testing two or more times in the prior 12 months. Over half of the respondents (59%) reported ever taking a syphilis test with only 62 (14.1%) reporting testing three or more times in the prior 12 months. After adjusting for socio-demographics, attitude and norms, high perceived self-efficacy was associated with a 33% increase in the likelihood of repeated HIV testing [prevalence ratio (PR), 1.33, 95% confidence interval (CI) 1.15-1.53] while low perceived confidence was associated with a 25% decrease in the likelihood of repeated HIV testing (PR, 0.75, 95% CI 0.63-0.89). Similarly low attitudes and norms were associated with a decrease of 52.6% (PR, 0.47, 95% CI 0.37-0.61) and 47% (PR, 0.53, 95% CI 0.41-0.69) in the likelihood of repeated syphilis testing respectively. Compared to HIV, uptake of repeated syphilis testing was very low. Correlates of HIV testing include; perceived self-efficacy amidst barriers and perceived confidence for HIV and low attitudes and accepting norms for syphilis. Health campaigns should emphasize overcoming barriers to HIV testing while promoting attitudes and norms including integration of serological syphilis testing and other STIs into HIV services.