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Structural, interpersonal, psychosocial, and behavioral risk factors for HIV acquisition among female bar workers in Dar es Salaam, Tanzania

In sub-Saharan Africa, female bar workers (FBWs) often serve as informal sex workers. Little is known about the prevalence of HIV and HIV-related risk factors among FBWs in Dar es Salaam (DSM), Tanzania. Using an adapted Structural HIV Determinants Framework, we identified structural, interpersonal,...

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Main Authors: Barnhart, Dale A. (Author) , Harling, Guy (Author) , Muya, Aisa (Author) , Ortblad, Katrina (Author) , Mashasi, Irene (Author) , Dambach, Peter (Author) , Ulenga, Nzovu (Author) , Mboggo, Eric (Author) , Oldenburg, Catherine (Author) , Bärnighausen, Till (Author) , Spiegelman, Donna (Author)
Format: Article (Journal)
Language:English
Published: 12 May 2019
In: AIDS care
Year: 2019, Volume: 31, Issue: 9, Pages: 1096-1105
ISSN:1360-0451
DOI:10.1080/09540121.2019.1612018
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1080/09540121.2019.1612018
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Author Notes:Dale A. Barnhart, Guy Harling, Aisa Muya, Katrina F. Ortblad, Irene Mashasi, Peter Dambach, Nzovu Ulenga, Eric Mboggo, Catherine E. Oldenburg, Till W. Bärnighausen, Donna Spiegelman
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Summary:In sub-Saharan Africa, female bar workers (FBWs) often serve as informal sex workers. Little is known about the prevalence of HIV and HIV-related risk factors among FBWs in Dar es Salaam (DSM), Tanzania. Using an adapted Structural HIV Determinants Framework, we identified structural, interpersonal, psychosocial, and behavioral risk factors for HIV acquisition. We compared the prevalence of HIV and HIV-related risk factors among a random sample of 66 FBWs from DSM to an age-standardized, representative sample of female DSM-residents from the 2016 Demographic and Health and 2011-2012 AIDS Indicator Surveys. Compared to other women in DSM, FBWs had elevated prevalence of all four groups of risk factors. Key risk factors included gender and economic inequalities (structural); sexual violence and challenges negotiating condom use (interpersonal); depression, post-traumatic stress disorder, and low social support (psychosocial); and history of unprotected sex, multiple sex partners, and high alcohol consumption (behavioral). HIV prevalence did not differ between FBWs (7.1%, 95% CI 3.7-13.3%) and survey respondents (7.7%, 95% CI: 5.3-11.1%), perhaps due to FBWs’ higher - though sub-optimal - engagement with HIV prevention strategies. Elevated exposure to HIV-related risk factors but low HIV prevalence suggests economic, psychosocial, and biomedical interventions may prevent HIV among FBWs in DSM.
Item Description:Gesehen am 08.06.2020
Physical Description:Online Resource
ISSN:1360-0451
DOI:10.1080/09540121.2019.1612018

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