Open AccessMapping and size estimates of female sex workers in Cameroon: Toward informed policy for design and implementation in the national HIV program
Author(s) -
Serge Clotaire Billong,
Georges NguefackTsague,
Joseph Fokam,
Faran Emmanuel,
Shajy Isac,
Raoul A. T. Fodjo,
Marie Nicole Ngoufack,
Sylvie Kwedi,
Laure Vartan Moukam,
Thomas Tchetmi,
Vincent K. Tapka,
Alexis Ndjolo,
Zara Shubber,
Nejma Cheikh,
James Blanchard,
Jean-Bosco Nfetam Elat,
Elizabeth Mziray
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0212315
Subject(s) - poisson regression , demography , female sex , population , human immunodeficiency virus (hiv) , geography , psychological intervention , cross sectional study , sex work , medicine , socioeconomics , environmental health , statistics , mathematics , family medicine , sociology , psychiatry
Background Due to high HIV prevalence among Female Sex Workers (FSWs) in Cameroon (36.5%), this population is especially vulnerable to HIV acquisition and transmission nationwide. Though being prioritized in the national HIV response, it would be relevant to generate statistics on the number of FSWs in order to guide HIV interventions among FSWs. Our objective was to estimate the size of FSWs within hotspots of Cameroon. Methods A cross-sectional study was conducted from September-November 2015 in selected cities in Cameroon: Bafoussam, Bamenda, Bertoua, Buea, Douala, Kribi, Limbé, and Yaoundé. A programmatic mapping was used, consisting of interviews with secondary key informants (KI) to identify hotspots of FSWs and their respective estimated numbers. Validation of size estimates was done by interviews with FSW at each hotspot. Size estimations in the councils mapped were extended to others not mapped using a Poisson regression model. Results A total of 2,194 hotspots were identified: Douala (760), Yaoundé (622), Bamenda (263), Bafoussam (194), Kribi (154), Bertoua (140), Limbé (35), and Buea (26). The estimated total number (range) of FSWs was 21,124 (16,079–26,170), distributed per city as follows: Douala 7,557 (5,550–9,364), Yaoundé 6,596 (4,712–8,480), Bafoussam 2,458 (1,994–2,923), Bamenda 1,975 (1,605–2,345), Kribi 1,121 (832–1,408), Bertoua 1,044 (891–1,198), Buea 225 (185–266), and Limbé 148 (110–148). The variability of estimates among cities was also observed within the councils of each city. The national predicted estimate of FSW population was 112,580 (103,436–121,723), covering all councils of Cameroon. An estimate of 1.91% (112,580/5,881,526; 0.47%-3.36%) adult female population in Cameroon could be sex workers. Conclusion There are considerable numbers of FSW in major cities in Cameroon. There is a need to prioritize interventions for HIV prevention toward this population in order to limit the burden of HIV sexual transmission nationwide.