Part time female sex workers in a suburban community in Kenya: a vulnerable hidden population

BACKGROUND: In sub-Saharan Africa, female sex workers (FSWs) are a vulnerable high risk group for the acquisition and transmission of sexually transmitted infections (STI) and HIV. OBJECTIVES: To study parameters of sexual behaviour and knowledge of STI and HIV, to describe health seeking behaviour related to STI, and to measure the prevalence of gonorrhoea, chlamydia, syphilis, and HIV-1, to provide baseline data for targeted STI and HIV prevention interventions. METHODS: In a cross sectional survey with snowballing recruitment, between February and March 2000, 503 self identified FSWs in a suburb in Mombasa, Kenya, were interviewed with a structured questionnaire and screened for gonorrhoea, chlamydia, syphilis, and HIV-1. RESULTS: The mean number of sexual partners in the previous week was 2. 8 (SD 1. 6). The mean number of non-regular clients and regular clients in the previous week was 1. 5 (1. 0) and 1. 0 (0. 9) respectively. The median weekly income from sex work was US15. A total of 337 (67%) women had an alternative income in the informal sector. 146 (29%) and 145 (45%) never used a condom with a client and non-paying partner respectively. The prevalence of gonorrhoea, chlamydia, and syphilis was 1. 8%, 4. 2%, and 2. 0% respectively. The overall HIV-1 seroprevalence was 30. 6%. CONCLUSIONS: There is a large need for intensive STI and HIV prevention interventions in part time FSW.