Prevalence of STI/HIV and factors associated with STI among female sex workers in Ecuador

Background: Female sex workers (FSWs) constitute a high risk population for STIs in many countries and should be an important target population for a public health response to the STIs and the HIV epidemic.

Objective: To estimate the prevalence of HIV and STIs, and identify the risk factors for STIs among FSWs in Ecuador.

Methods:  Data from 270 FSWs in Ecuador recruited by respondent driven sampling were analyzed. Through face-to-face interviews, structured questionnaires were administered and blood samples were obtained and tested for HIV and syphilis. Univariate and bivariate analyses were done. Multivariable binomial regression analyses were conducted to estimate adjusted prevalence ratios (APRs) of self-reported STI in the last three months.

Results: The prevalence of HIV infection, syphilis and self-reported STIs were 0.7%, 3.3% and 26.4 % respectively. The age of the respondents ranged from 18-54 years, and 248 (91.9%) reported always using condom with their clients. FSWs who did not know of any infection transmitted by sex were twice as likely to report STI (APR=2.18, 95% CI=1.06, 4.46). STI was also more prevalent among ‘single/divorced/widowed’ FSWs than among ‘married/cohabiting’ FSWs, and among those without a stable partner in comparison to those with a stable partner (p-value <0.05).

Conclusions: The prevalence of HIV and syphilis was low among participating FSWs in Ecuador. However, the prevalence of self-reported STIs was high and associated with knowledge of STI transmission, stable partner and marital status. There is need for increased awareness on STI transmission and STIs prevention interventions among FSWs in Ecuador.