Evaluation of Parametric Statistical Methods in Predicting Factors Influencing Hepatitis B and HIV Among Female Sex Workers

Abstract

Purpose This study evaluates parametric statistical methods, including logistic regression, Poisson regression, and Cox proportional hazards models, to determine factors influencing Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV) infections among female sex workers (FSWs) in Ghana. The research focuses on infection prevalence and the effectiveness of the Cox model in identifying significant predictors. Methods A cross-sectional survey with biological sampling and structured interviews was conducted among 7,000 participants. Time Location Sampling ensured representativeness. The prevalence of HBV and HIV was calculated, and a Cox proportional hazards model was used to identify significant predictors, with hazard ratios (HR) and p-values evaluated to measure risk associations. Results HBV prevalence was 6.53% (95% CI: 6.08–7.01%), and HIV prevalence was 4.53% (95% CI: 3.46–5.92%). Significant predictors for HBV included alcohol use during sex (HR = 1.34, p = 0.042) and healthcare avoidance due to stigma (HR = 1.64, p = 0.023). For HIV, older age was strongly associated with increased risk, with hazard ratios of 1.60 (p = 0.007) for ages 25–35 and 2.20 (p = 0.001) for ages above 35. Education was a protective factor for HIV, with secondary education reducing risk by 67% (HR = 0.33, p < 0.001) and higher education by 60% (HR = 0.40, p = 0.019). The Cox model outperformed logistic and Poisson regression, demonstrating superior discriminatory ability. Conclusions University of Ghana http://ugspace.ug.edu.gh The Cox proportional hazards model provided robust identification of risk factors for HBV and HIV. Behavioural and systemic determinants like alcohol use, stigma, age, and education significantly influenced infection risks. These findings underscore the need for targeted public health interventions, particularly addressing alcohol-related behaviours, stigma, and health literacy.