A Behavioral and Serological Survey on HIV Prevalence Among Prisoners in Benin.

Cases of HIV are common in Benin, with infection rates varying according to socioeconomic and cultural factors, and by region. Certain segments of the population, such as prison inmates, sex worker clients and truck drivers are at high risk for HIV/AIDS. The aim of this study is to identify which behavioral and serological indicators contribute to the spread of HIV among prisoners. A total of 496 inmates from prisons located in all major cities in Benin were surveyed. Data was collected through interview sessions carried out using a questionnaire and through blood samples. The results show that most inmates are Beninese (83.5%), and the average age is 33 years (range: 14-80 years). No prisoner reported using a condom the last time they engaged in sexual intercourse. Blood exposure was found in 14.6% of inmates and HIV was detected in 1.4% of cases. Our analysis indicates that the length of detention and gender are factors that influence HIV status. However, age, education, nationality and HIV awareness had no significant effect on HIV prevalence among inmates. The results highlight the need to raise awareness in prisons about HIV. This can be achieved by strengthening communication strategies and by organizing HIV and sexually transmitted diseases information sessions for both prison officers and inmates.

[HIV and sexually transmitted disease among female sex workers in Benin]. / VIH et infections sexuellement transmissibles chez les travailleuses du sexe au Bénin.

BACKGROUND: This report describes a follow-up study conducted in 2005 to evaluate programs intended to reduce HIV/AIDS among registered and unregistered female sex workers (FSW) and their male clients in six major urban areas in Benin (Cotonou, Abomey-Bohicon, Parakou, Porto-Novo, Kandi, Malanville). The objectives of this second study combining laboratory testing and behavioral questionnaires were to estimate the prevalence of HIV and sexually transmitted diseases (STI), to determine the sociodemographic and behavioral characteristics of FSW, and to assess changes in the behavior of registered FSW in the first four cites (Cotonou, Abomey-Bohicon, Parakou, and Porto-Novo) included in the initial study in 2002. DESIGN AND METHODS: A cross-sectional study was conducted in a cohort of 930 self-identified FSW. The chi-square or Fisher's exact test were used to test correlation between HIV and social, demographic and behavioral factors and the Wilcoxon test to compare the distribution of continuous variables. Correlation was measured based on prevalence odd ratios (POR) obtained by multivariate logistic regression. RESULTS: The overall prevalence of HIV, Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) were 30.5%, 3.6% and 5.7% respectively. The prevalence of HIV was highest in Parakou (48.2%) and lowest in Abomey/Bohicon (16.4%). The prevalence of NG and CT were highest in Abomey/Bohicon and Porto-Nova respectively. Multivariate logistic regression analysis showed that HIV prevalence increased significantly for FSW who had had more than 10 clients in the previous week (POR = 1.40, 95% CI: 1.02-1.94), who had no other source of income (POR = 1.47, 95% CI: 1.08-2.00), who were currently unmarried or separated (POR = 2.63, 95% CI: 1.73-4.02), and who had never been married (POR = 2.07, 95% CI: 1.43-3.00). Older age and having had no non-paying partner in the last seven days were positively correlated with HIV infection. Between 2002 and 2005 there was a significant increase in the number of FSW who reported condom use with all clients (79% vs. 90%, p < 0.0001) and with all sexual partners (78% vs. 87%, p = 0.0007) during the last 7 days as well as in the median number of visits to a health care facility in the last 12 days (3 vs. 6, p < 0.0001). Overall these follow-up data showed a large decrease in the prevalence of HIV/STI. This finding supports continuation of programs aimed at FSW especially with regard to risk awareness, condom use, and STI screening and treatment.

VIH et infections sexuellement transmissibles chez les travailleuses du sexe au Benin

Dans le cadre du suivi des programmes de prevention du VIH/SIDA et autres infections sexuellement transmissibles visant les travailleuses du sexe (TS) affichees ou clandestines et leurs clients masculins en Republique du Benin; une seconde etude transversale a ete realisee en 2005 aupres de 930 TS dans six grands centres urbains (Cotonou; Abomey-Bohicon; Parakou; Porto-Novo; Kandi; Malanville). Les buts de cette deuxieme etude etaient d'estimer la prevalence duVIH et des IST; de decrire les caracteristiques socio-demographiques et comportementales des TS; ainsi que d'evaluer les changements obtenus chez les TS affichees dans les quatre premiers centres urbains (Cotonou; Abomey-Bohicon; Parakou; Porto-Novo) ayant fait partie de la premiere etude de 2002. Les prevalences globales du VIH; de Neisseria gonorrhoeae (NG) et Chlamydia trachomatis (CT) etaient respectivement de 30;5; 3;6et 5;7. La ville de Parakou avait la prevalence la plus elevee du VIH (48;2) alors que Abomey/Bohicon avait la plus faible (16;4). Par contre; la prevalence du NG et du CT etait plus elevee respectivement a Abomey/Bohicon et a Porto-Novo. En analyse multivariee par regression logistique; la prevalence du VIH augmentait significativement lorsque les TS avaient eu plus de 10 clients la derniere semaine (Rapport de cote de prevalence (RCP)=1;40; IC95: 1;02-1;94); n'avaient pas d'autre source de revenus (RCP=1;47; IC95: 1;08-2;00); n'etaient pas actuellement mariees ou vivant maritalement (RCP=2;63; IC95: 1;73-4;02); mais l'avaient deja ete (RCP=2;07; IC95: 1;43-3;00). L'age plus avance et le fait de ne pas avoir eu de partenaire non payant les sept derniers jours etaient aussi positivement associes a l'infection par le VIH. Entre 2002 et 2005; l'utilisation du preservatif avec tous les clients (79vs 90; p0;0001) comme avec tous les partenaires sexuels (78vs 87; p=0;0007) au cours des sept derniers jours; ainsi que le nombre median de visites dans une structure de soins les 12 derniers mois (3 vs 6; p0;0001) ont significativement augmente. Globalement; il y a eu une diminution importante de la prevalence duVIH/IST dans cette deuxieme enquete.Ainsi; les interventions de prevention visant les TS devraient etre maintenues; surtout en ce qui concerne l'education; la promotion et la gestion du preservatif; le depistage et le traitement des IST