HIV/AIDS and Nigerian female sex workers : Rural- urban differentials in HIV testing behavior and condom use

Background: Female sex workers (FSWs) have played a critical role in facilitating heterosexual transmission of HIV and remain an important high-risk population. This exploratory study examined differences in HIV testing behavior and condom use among brothel-based FSWs in rural and urban communities in Nigeria.

Methods: A cross sectional study was conducted among a sample of 137 FSWs from two sites in March 2011. A short questionnaire with demographic, HIV testing, and condom-use variables was administered to the participants via a person-to-person interview. All analyses used the Statistical Package for Social Sciences (SPSS) for windows version 19 and Chi-square tests were used to examine differences between the two groups.

Results: Significantly higher percentages of urban FSWs reported they have been tested for HIV (84.3% vs. 62.6%; p=0.014), and have consistently used condom with their clients during sex (81.4% vs. 59.7%; p<0.001). However, there were no significant differences between urban and rural FSWs in their awareness of HIV/AIDS disease and perception of being at risk for HIV infection. All participants reported they were aware of HIV/AIDS disease and 88.5 percent of urban FSWs perceived they were at risk of HIV infection compared with 86.5 percent of rural FSWs.

Conclusion: There were significant rural-urban differences in HIV testing behavior and consistent use of condom among the FSWs. The findings suggest there is greater need in rural areas for specific interventions that focus on promoting HIV testing and improving condom self-efficacy in FSWs. Programs targeting FSWs to make objective assessment of their risk for HIV infection should be reinforced.