Estimation of the size of the female sex worker population in Rwanda using three different methods.

HIV prevalence is disproportionately high among female sex workers compared to the general population. Many African countries lack useful data on the size of female sex worker populations to inform national HIV programmes. A female sex worker size estimation exercise using three different venue-based methodologies was conducted among female sex workers in all provinces of Rwanda in August 2010. The female sex worker national population size was estimated using capture-recapture and enumeration methods, and the multiplier method was used to estimate the size of the female sex worker population in Kigali. A structured questionnaire was also used to supplement the data. The estimated number of female sex workers by the capture-recapture method was 3205 (95% confidence interval: 2998-3412). The female sex worker size was estimated at 3348 using the enumeration method. In Kigali, the female sex worker size was estimated at 2253 (95% confidence interval: 1916-2524) using the multiplier method. Nearly 80% of all female sex workers in Rwanda were found to be based in the capital, Kigali. This study provided a first-time estimate of the female sex worker population size in Rwanda using capture-recapture, enumeration, and multiplier methods. The capture-recapture and enumeration methods provided similar estimates of female sex worker in Rwanda. Combination of such size estimation methods is feasible and productive in low-resource settings and should be considered vital to inform national HIV programmes.

High HIV risk behavior among men who have sex with men in Kigali, Rwanda: making the case for supportive prevention policy.

Rwanda has responded strongly to HIV/AIDS, but prevention among men who have sex with men (MSM) has not yet been addressed due to a strong cultural resistance to homosexuality, and a lack of data showing the public health value of attending to the sexual health needs of this group. We conducted an exploratory study on HIV risk among MSM in Kigali using snowball sampling involving peer leaders. The 99 respondents were demographically, socially, and sexually diverse. Respondents reported relatively high numbers of male and female partners, and considerable HIV risk behaviors including commercial sex with men and women, low condom use during anal and vaginal sex, and high mobility. Many respondents reported verbal and/or physical abuse due to their sexuality. This first study of MSM in Rwanda has brought attention to a previously neglected HIV risk group and their potential driving role in the Rwandan epidemic, demonstrating the need for sensitive and targeted interventions.

The reach and effect of radio communication campaigns on condom use in Malawi.

This study uses data from the 2004 Malawi Demographic and Health Survey to assess the reach of selected radio programs about family planning and health in Malawi and their effect on condom use and discussion of family planning. The results show that such radio programs in Malawi reach a broad audience: eight of the 12 programs were heard by at least half of the respondents, although women were less effectively reached than men. For both women and men, the radio programs were found to have a significant impact on family planning discussion with one's partner. The programs' effect on condom use was limited, however. A positive association was found with ever use of condoms, but no association was found with condom use at last intercourse. This limited impact suggests that such radio communication campaigns need to be informed by research identifying the specific constraints to current condom use in Malawi.