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Infectious Diseases in Obstetrics and Gynecology
Volume 2014, Article ID 296245, 9 pages
Research Article

Safer Conception Needs for HIV Prevention among Female Sex Workers in Burkina Faso and Togo

1Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, E7138, Baltimore, MD 21205, USA
2Programme d’Appui au Monde Associatif et Communautaire (PAMAC), 11 BP 1023 Ouagadougou, Burkina Faso
3Arc en Ciel, 80295 Lomé, Togo
4Institut de Recherche en Sciences de la Santé (IRSS/CNRST), 03 BP 7192 Ouagadougou, Burkina Faso
5Conseil National de Lutte contre le SIDA du Togo (National AIDS Council), Faculté des Sciences de la Santé, Université de Lomé, 01 BP 2237 Lomé, Togo

Received 30 June 2014; Revised 7 October 2014; Accepted 8 October 2014; Published 23 October 2014

Academic Editor: Gregory T. Spear

Copyright © 2014 Sheree R. Schwartz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Reproductive health programming for female sex workers (FSW) may include contraceptive services but rarely addresses safer pregnancy planning. Methods. Adult FSW were enrolled into a cross-sectional study across four sites in Burkina Faso and Togo using respondent-driven sampling. Sociobehavioral questionnaires and HIV counseling and testing were administered. Sample statistics and engagement in HIV treatment were described and compared using Chi-squared statistics. Results. 1,349 reproductive-aged FSW were enrolled from January to July 2013. Overall, 267 FSW (19.8%) were currently trying to conceive. FSW trying to conceive were more likely to test positive for HIV at enrollment as compared to women not trying to become pregnant (24.5% versus 17.7%, ); however awareness of HIV status was similar across groups. Among FSW trying to conceive, 79.0% (211/267) had previously received HIV testing, yet only 33.8% (23/68) of HIV-infected FSW reported a previous HIV diagnosis. Overall 25.0% (17/68) of HIV-infected FSW trying to conceive were on antiretroviral therapy. Conclusion. FSW frequently desire children. However engagement in the HIV prevention and treatment cascade among FSW trying to conceive is poor potentiating periconception transmission risks to partners and infants. Programs to facilitate earlier HIV diagnosis for FSW and safer conception counseling are needed as components of effective combination HIV prevention services.