The effect of drop-in centers on access to HIV testing, case finding, and condom use among female sex workers in Addis Ababa, Ethiopia

Saro Abdella Abrahim; Meaza Demissie; Alemayehu Worku; Merga Dheresa; Yemane Berhane

doi:10.7717/peerj.16144

The effect of drop-in centers on access to HIV testing, case finding, and condom use among female sex workers in Addis Ababa, Ethiopia

PeerJ. 2023 Oct 17:11:e16144. doi: 10.7717/peerj.16144. eCollection 2023.

Authors

Saro Abdella Abrahim¹, Meaza Demissie², Alemayehu Worku³, Merga Dheresa⁴, Yemane Berhane⁵

Affiliations

¹ HIV and TB Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
² Department of Global Health and Health Policy, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
³ School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
⁴ School of Nursing and Midwifery, College of Health Sciences, Haramaya University, Harar, Ethiopia.
⁵ Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.

Abstract

Background: Varied HIV prevention interventions involving multiple strategies has been instrumental in the effort to contain and lessen the prevalence of HIV around the globe. However, female sex workers (FSWs) often face stigma and discriminatory challenges, resulting in lower access to the HIV prevention initiatives. This study has aimed to assess the effect of one of the HIV service delivery models, the Drop-in Centers (DICs), which is designed to overcome the service uptake barriers of FSWs.

Method: A quasi-experimental study design was employed. A respondent-driven sampling technique was used to recruit 1,366 FSWs from January to June 2020. A propensity score matching technique was used to balance the potential confounders between FSWs who had access to DICs and those who had never accessed DICs. Comparisons of the effect of DIC on the outcome of interest was made using a logit regression model at a 5% level of significance.

Results: A total of 1,366 FSWs took part in the study. The analysis estimated the average treatment effects of access to DICs on four key outcomes: ever-testing to know HIV status, finding HIV-positive FSWs, awareness of HIV-positive status, and consistent condom use. A significant effect of DIC was seen at a 95% confidence interval on each outcome. Access to DIC produced a 7.58% increase in the probability of testing to know HIV status (P < 0.001), a 7.02% increment in finding HIV-positive FSWs (P = 0.003), an increase of 6.93% in awareness of HIV status among HIV positive FSWs (P = 0.001), and a 4.39% rise in consistent condom use (P = 0.01).

Conclusions: Ensuring access of FSWs to DICs has led to an upsurge in HIV testing among FSWs, raising HIV status awareness among those who are HIV positive, and encouraged consistent condom use. To provide effective HIV prevention services, particularly to those FSWs living with HIV, it is essential to strengthen the services provided in DICs and expand the centers. This will ensure that the entire network of FSWs is reached with appropriate HIV prevention services.

Keywords: Combination intervention; DIC; FSW; HIV test; Key population; Safe space.

MeSH terms

Condoms
Ethiopia / epidemiology
Female
HIV Infections* / diagnosis
HIV Testing
Humans
Sex Workers*

Grants and funding

The authors received no funding for this work.