Factors associated with HIV-1 infection among sex workers of Addis Ababa, Ethiopia

Objective: To study the prevalence and risk factors for HIV infection among sex workers of Addis Ababa, Ethiopia. Design and methods: Cross-sectional survey on socio-demographic characteris tics, behaviours, and HIV serological status of sex workers attending two h ealth centres of Addis Ababa. Results: HIV prevalence among sex workers was 274 of 372 (73.7%). Several f actors were significantly associated with an increased risk of being HIV-in fected [among others, working in 'shared rooms', high number of clients, us e of injectable hormones, and positive Treponema pallidum particle agglutin ation (TPPA) serology], and others with a decreased risk (being born in Add is Ababa, high level of education, peer education on sex work, condom use, use of oral pill, and use of condoms for contraception). Of interest, sex w orkers who were using condoms for contraception were, compared with others, more likely to use condoms consistently (65 versus 24%, respectively; P < 0.001), and less likely to be HIV-infected (55 Versus 86%, respectively; P < 0.001). In multivariate analysis [log-binomial model, giving estimates of the prevalence ratio (PR)], being born in Addis Ababa (PR = 0.74; 95% conf idence interval (CI), 0.61-0.91), using condoms for contraception (PR = 0.7 3; 95% Cl, 0.64-0.85), and a positive TPPA serology (PR = 1.21; 95% CI, 1.0 9-1.36), remained significantly associated with HIV infection. Conclusions: HIV prevalence was remarkably high among sex workers of Addis Ababa. Condom use was higher, and HIV prevalence lower, in sex workers usin g condoms not only for prevention of HIV and sexually transmitted diseases, but also for contraceptive purpose. This finding is of particular interest for its implications for prevention strategies among sex workers in the de veloping world. (C) 2001 Lippincott Williams & Wilkins.