Abstract:
Background: The HIV epidemic in Ghana is characterized as a mix of a low-level generalized epidemic with significant contributions from transmission
among female sex workers (FSW) and their clients. This study seeks to identify
and describe key characteristics and sexual behaviors of FSW and estimate the
prevalence of HIV, syphilis, gonorrhea, chlamydia, and hepatitis B virus (HBV)
among FSW in Ghana.
Method: A total of 7,000 FSW were recruited for the study using Time and location.
Sampling (TLS) approach, with 5,990 (85.6%) participants completing both
biological and behavioral aspects of the study. A structured questionnaire
was administered to respondents to assess several factors, such as background
characteristics, sexual risk behaviors, condom usage, HIV/AIDS knowledge,
opinions, and attitudes. Trained staff conducted face-to-face interviews using
mobile data collection software (REDCap) after provision of specimens for HIV and
STI testing. Descriptive statistics such as medians, ranges, charts, and percentages
are performed and presented. Also included are bivariate analyses to establish
relationships between FSW type and other relevant characteristics of the study.
Results: Among the 7,000 (100%) FSW sampled from all regions, 6,773 took part
in the behavioral and 6,217 the biological. There were 783 (11.2%) respondents
who took part only in the behavioral and 227 (3.2%) only in the biological. Most
were young, with a median age of 26 years; the majority had never been married or
were widowed/divorced and a quarter had no education or had only primary
education. majority (74.8%) of FSW first sold sex at age 25 years or less with a
median age of 20 years. Most (84.8%) of the FSW indicated that they entered sex
work for money, either for themselves or their families, and had an average of eleven (11) sexual
partners per week. More than half (55.2%) of the FSW were new entrants who
had been in sex work for less than 5 years before the study. Consistent condom
use with paying clients was generally unsatisfactory (71%), and was, however,
very low (24%) with their intimate partners or boyfriends. Only about half (54.6%)
of FSW have been exposed to HIV prevention services in the last three months
preceding the survey, and this varies across regions. Overall, comprehensive
