Effects of Exposure to an Intensive HIV-prevention Programme on Behavioural Changes among Female Sex Workers in Nairobi, Kenya

While Kenya has had a long-standing national HIV-prevention program, evidence on the level of exposure to its interventions and related effects on behavioral changes among female sex workers (FSWs) is limited. Using cross-sectional behavioral data collected in 2013 from 1 357 FSWs aged 18 years and...

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Main Authors: Prakash, Ravi, Bhattacharjee, Parinita, Blanchard, Andrea, Musyoki, Helgar, Anthony, John, Kimani, Joshua, Gakii, Gloria, Sirengo, Martin, Muraguri, Nicholas, Mziray, Elizabeth, Kasonde, Lombe, Blanchard, James, Isac, Shajy, Moses, Stephen
Format: Journal Article
Published: Taylor and Francis 2018
Subjects:
Online Access:http://hdl.handle.net/10986/30218
id okr-10986-30218
recordtype oai_dc
spelling okr-10986-302182021-05-25T10:54:40Z Effects of Exposure to an Intensive HIV-prevention Programme on Behavioural Changes among Female Sex Workers in Nairobi, Kenya Prakash, Ravi Bhattacharjee, Parinita Blanchard, Andrea Musyoki, Helgar Anthony, John Kimani, Joshua Gakii, Gloria Sirengo, Martin Muraguri, Nicholas Mziray, Elizabeth Kasonde, Lombe Blanchard, James Isac, Shajy Moses, Stephen BEHAVIOR MODIFICATION BEHAVIORAL ECONOMICS CONDOM USE EMPOWERMENT SEXUALLY TRANSMITTED INFECTION VIOLENCE AGAINST WOMEN HIV PREVENTION While Kenya has had a long-standing national HIV-prevention program, evidence on the level of exposure to its interventions and related effects on behavioral changes among female sex workers (FSWs) is limited. Using cross-sectional behavioral data collected in 2013 from 1 357 FSWs aged 18 years and above in Nairobi, Kenya, this study explores the relationship between FSW program exposure levels and behavioral outcomes including condom use, sexually transmitted infection (STI)-treatment, and empowerment measures like disclosure of self-identity and violence reporting. We categorized program exposure levels as none, moderate and intensive. Multivariate logistic regression was used for analysis. Overall, 35% of the FSWs were not exposed to any HIV prevention program, whereas about 24% had moderate and 41% had intensive exposure. FSWs having intensive program exposure had a higher likelihood of using condoms consistently with occasional clients (AOR: 1.57; 95% CI: 1.08–2.31) and seeking treatment for STIs (AOR: 3.37; 95% CI: 1.63–7.02) compared to FSWs with no or moderate exposure. Intensive program exposure was also associated with higher self-disclosure of sex-work identity (AOR: 1.63; 95% CI: 1.19–2.24), reporting of violence to police (AOR: 2.45; 95% CI: 1.03–5.84), and negotiation of condom use at last sex when the client was under the influence of alcohol (AOR: 1.63; 95% CI: 0.94–2.82). Although HIV prevention programs in Kenya have been underway for over a decade, program efforts were largely focused on saturating the coverage (intervention breadth). Strategies should now focus on ensuring improved quality of contacts through intensified program exposure (intervention depth) to enhance gains in behavioral change among FSWs and preventing the burden of HIV infection among them. 2018-08-15T14:31:53Z 2018-08-15T14:31:53Z 2018-03-08 Journal Article African Journal of AIDS Research 1608-5906 http://hdl.handle.net/10986/30218 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank Taylor and Francis Publications & Research :: Journal Article Publications & Research Africa Kenya
repository_type Digital Repository
institution_category Foreign Institution
institution Digital Repositories
building World Bank Open Knowledge Repository
collection World Bank
topic BEHAVIOR MODIFICATION
BEHAVIORAL ECONOMICS
CONDOM USE
EMPOWERMENT
SEXUALLY TRANSMITTED INFECTION
VIOLENCE AGAINST WOMEN
HIV PREVENTION
spellingShingle BEHAVIOR MODIFICATION
BEHAVIORAL ECONOMICS
CONDOM USE
EMPOWERMENT
SEXUALLY TRANSMITTED INFECTION
VIOLENCE AGAINST WOMEN
HIV PREVENTION
Prakash, Ravi
Bhattacharjee, Parinita
Blanchard, Andrea
Musyoki, Helgar
Anthony, John
Kimani, Joshua
Gakii, Gloria
Sirengo, Martin
Muraguri, Nicholas
Mziray, Elizabeth
Kasonde, Lombe
Blanchard, James
Isac, Shajy
Moses, Stephen
Effects of Exposure to an Intensive HIV-prevention Programme on Behavioural Changes among Female Sex Workers in Nairobi, Kenya
geographic_facet Africa
Kenya
description While Kenya has had a long-standing national HIV-prevention program, evidence on the level of exposure to its interventions and related effects on behavioral changes among female sex workers (FSWs) is limited. Using cross-sectional behavioral data collected in 2013 from 1 357 FSWs aged 18 years and above in Nairobi, Kenya, this study explores the relationship between FSW program exposure levels and behavioral outcomes including condom use, sexually transmitted infection (STI)-treatment, and empowerment measures like disclosure of self-identity and violence reporting. We categorized program exposure levels as none, moderate and intensive. Multivariate logistic regression was used for analysis. Overall, 35% of the FSWs were not exposed to any HIV prevention program, whereas about 24% had moderate and 41% had intensive exposure. FSWs having intensive program exposure had a higher likelihood of using condoms consistently with occasional clients (AOR: 1.57; 95% CI: 1.08–2.31) and seeking treatment for STIs (AOR: 3.37; 95% CI: 1.63–7.02) compared to FSWs with no or moderate exposure. Intensive program exposure was also associated with higher self-disclosure of sex-work identity (AOR: 1.63; 95% CI: 1.19–2.24), reporting of violence to police (AOR: 2.45; 95% CI: 1.03–5.84), and negotiation of condom use at last sex when the client was under the influence of alcohol (AOR: 1.63; 95% CI: 0.94–2.82). Although HIV prevention programs in Kenya have been underway for over a decade, program efforts were largely focused on saturating the coverage (intervention breadth). Strategies should now focus on ensuring improved quality of contacts through intensified program exposure (intervention depth) to enhance gains in behavioral change among FSWs and preventing the burden of HIV infection among them.
format Journal Article
author Prakash, Ravi
Bhattacharjee, Parinita
Blanchard, Andrea
Musyoki, Helgar
Anthony, John
Kimani, Joshua
Gakii, Gloria
Sirengo, Martin
Muraguri, Nicholas
Mziray, Elizabeth
Kasonde, Lombe
Blanchard, James
Isac, Shajy
Moses, Stephen
author_facet Prakash, Ravi
Bhattacharjee, Parinita
Blanchard, Andrea
Musyoki, Helgar
Anthony, John
Kimani, Joshua
Gakii, Gloria
Sirengo, Martin
Muraguri, Nicholas
Mziray, Elizabeth
Kasonde, Lombe
Blanchard, James
Isac, Shajy
Moses, Stephen
author_sort Prakash, Ravi
title Effects of Exposure to an Intensive HIV-prevention Programme on Behavioural Changes among Female Sex Workers in Nairobi, Kenya
title_short Effects of Exposure to an Intensive HIV-prevention Programme on Behavioural Changes among Female Sex Workers in Nairobi, Kenya
title_full Effects of Exposure to an Intensive HIV-prevention Programme on Behavioural Changes among Female Sex Workers in Nairobi, Kenya
title_fullStr Effects of Exposure to an Intensive HIV-prevention Programme on Behavioural Changes among Female Sex Workers in Nairobi, Kenya
title_full_unstemmed Effects of Exposure to an Intensive HIV-prevention Programme on Behavioural Changes among Female Sex Workers in Nairobi, Kenya
title_sort effects of exposure to an intensive hiv-prevention programme on behavioural changes among female sex workers in nairobi, kenya
publisher Taylor and Francis
publishDate 2018
url http://hdl.handle.net/10986/30218
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