HIV prevalence and risk behaviors among clients of female sex workers in Gonaïves and St-Marc, Haïti

Marie-Claude Couture
Julio C. Soto
Edit Akom
Annie-Claude Labbé,Gerard Joseph,Maria-Victoria Zunzunegui

Contexte :
To examine socio-demographic characteristics, risk behaviours and STI (HIV, HSV-2, syphilis) prevalence of clients of female sex workers (FSWs) in the region of Artibonite in Haïti

Méthode :
A cross-sectional survey among clients of FSWs in the cities of Gonaïves and St-Marc, Artibonite region, Haiti. Clients were recruited from commercial sex sites and data were collected using a structured questionnaire. Dried blood spot (DBS) samples were used to determine prevalence of HIV, syphilis and Herpes simplex virus 2 (HSV-2). This study was part of the Projet D'Appui à la Lutte contre les ITS/VIH/SIDA en Haiti (PALIH).

Résultats :
A total of 378 clients agreed to participate, and 351 (92%) provided a blood sample. Eighty-eight percent of them were younger than 30, and 60.7% were living with a partner (married or common-law union). Seventy-four percent of clients reported that they used a condom at the last sex encounter with a FSW, 59.9% with their casual sex partners and 55% with their stable sex partners. Clients of FSWs had a high number of sex partners: 39.9% reported having ten or more different partners in the last three months. The prevalence of HIV-1, past or active syphilis and HSV-2 among clients were 7.2%, 13.4% and 22% respectively. In multivariate analysis, clients who ever tried marijuana, were not Protestants, had a history of previous STI and infected by HSV-2 were more often infected by HIV.

Conclusion :
These preliminary results showed that STI prevalence was remarkably high among clients of FSWs of Gonaïves and St-Marc, and most of them were unaware of their serological status. These men had a high number of sex partners and condom use differed regarding the category of partner. Clients of FSW, likely acting as a bridge population facilitating the spread of HIV infection throughout the general population in Haiti, should be targeted in HIV prevention programs.