Prevalence of human immunodeficiency virus among female sex workers and associated risk factors in Rwanda, 2019

Background Female sex workers (FSWs) are more likely to be infected by Human immunodeficiency virus (HIV) than the general population. In Sub-Saharan countries, 18% of new HIV infections is attributed to FSWs. Study objective To determine HIV prevalence and its determinants among FSWs in Rwanda. Methodology A cross-sectional biological and behavioral surveillance survey in hotspots was conducted among FSWs countrywide. HIV laboratory tests were performed. Proportions and 95% confidence interval (CI) were calculated. Multivariable logistic regression was performed to determine factors associated with HIV in FSWs. Results The survey enrolled 1,883 FSWs. Of 1,770 FSWs who consented for HIV testing, 607 were HIV positive, giving the prevalence of 34% (95%CI= 32.11-36.54). High HIV prevalence was associated with age of 25 years or more (aOR = 3.68; 95%, CI: 2.62­5.18) and more than 5 years of sexwork (aOR = 1.31; 95% CI: 1.05­1.63). HIV prevalence and having more than three dependents (aOR= 0.34; 95%CI=0.23-0.5) and completing secondary and beyond education (aOR=0.50; 95%CI=0.36-0.71) were inversely related. Conclusion HIV prevalence is still high among FSWs in Rwanda. Prevention strategies should target the old ones in five first years of sex work and the less educated.