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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Transactional sex is the driving force in the dynamics of HIV in Accra, Ghana
AIDS, Volume 18, No. 6, Year 2004
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Description
Objective: To delineate the population attributable fraction (PAF) of transactional sex in prevalent cases of HIV infection in the male adult population of Accra, Ghana. Design and methods: Cross-sectional study of clients who visited a sex worker (SW), of boyfriends of SW and of male personnel in prostitution venues. A questionnaire was administered and urine obtained for detection of anti-HIV antibodies. The PAF of prevalent HIV acquired from SW was calculated using a combination of data from this survey of clients, from on-going SW surveys, the national HIV surveillance system and the national census. Results HIV prevalence was 4.9% (8/162) among clients of mobile SW, 15.8% (53/ 335) among clients of home-based SW, 17.5% (10/57) among personnel and 32.1% (9/28) among boyfriends. A condom was used in 90% of intercourses, according to clients. Non-use of a condom was clustered in selected locations and independently associated with older age of client, frequency of intercourse with SW in the last year and current urethritis. Among the male population of Accra aged 15-59 years, 84% of prevalent cases of HIV were attributable to transactional sex. A sensitivity analysis showed that under various assumptions PAF varied between 47% and 100%. Conclusions: In Accra, approximately four-fifths of prevalent cases of HIV in adult males were acquired from SW. Comprehensive interventions providing education, condoms and treatment for sexually transmitted diseases for SW and their clients should be approached as other public health priorities and provided in all cities, large and small, of West Africa. © 2004 Lippincott Williams & Wilkins.
Authors & Co-Authors
Cǒté, Anne Marie
Canada, Sherbrooke
Centre for International Health
Sobéla, François
Canada, Sherbrooke
Centre for International Health
Ghana, Accra
West Africa Project to Combat Aids
Dzokoto, Agnes Wilhelmina
Ghana, Accra
Ministry of Health Ghana
Nzambi, Khonde
Canada, Sherbrooke
Centre for International Health
Ghana, Accra
West Africa Project to Combat Aids
Asamoah-Adu, Comfort
Ghana, Accra
West Africa Project to Combat Aids
Ghana, Accra
Ministry of Health Ghana
Labbé, Annie Claude
Canada, Montreal
Hôpital Maisonneuve-rosemont
Benoît, Masse R.
United States, Seattle
Fred Hutchinson Cancer Research Center
Mensah, Joyce
Ghana, Accra
West Africa Project to Combat Aids
Ghana, Accra
Ministry of Health Ghana
Frost, Eric Harold E.
Canada, Sherbrooke
Université de Sherbrooke
Pépin, Jacques
Canada, Sherbrooke
Centre for International Health
Canada, Sherbrooke
Université de Sherbrooke
Statistics
Citations: 208
Authors: 10
Affiliations: 6
Identifiers
Doi:
10.1097/00002030-200404090-00009
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Multi-countries
Ghana
Participants Gender
Male