High acceptability of HIV voluntary counselling and testing among female sex workers: impact of individual and social factors

• Published in: HIV medicine Vol. 13; no. 3; pp. 156 - 165
• Main Authors: Aho, J, Nguyen, V‐K, Diakité, SL, Sow, A, Koushik, A, Rashed, S
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-03-2012
• Subjects: Abuse; Acquired immune deficiency syndrome; Adolescent; Adult; Cohort Studies; Counseling - organization & administration; Decision making; Female; female sex workers; Follow-Up Studies; Guinea - epidemiology; HIV Infections - epidemiology; HIV Infections - prevention & control; HIV Infections - psychology; HIV testing; Human immunodeficiency virus; Humans; Infection; Middle Aged; Patient Acceptance of Health Care - psychology; Patient Acceptance of Health Care - statistics & numerical data; Perception; Pressure; Prostitution; Risk factors; Risk groups; Self Disclosure; Sex Workers - psychology; Sex Workers - statistics & numerical data; Violence - psychology; Violence - statistics & numerical data; western Africa; Young Adult; Guinea
• ISSN: 1464-2662; 1468-1293
• DOI: 10.1111/j.1468-1293.2011.00951.x

Objectives
Voluntary counselling and testing (VCT) for HIV infection is an important tool for prevention of HIV infection and AIDS in high‐risk groups. Our goal was to describe the acceptability and consequences of VCT among a stigmatized and vulnerable group, female sex workers (FSWs), in Conakry, Guinea.
Methods
Acceptance of the test and return for test results at baseline and consequences of testing 1 year later were described. The perceived risk of HIV infection and perceived benefits and barriers to testing were examined using quantitative and qualitative methods.
Results
All 421 FSW participants agreed to undergo VCT and most participants (92%) returned for their results. The main reason cited for VCT acceptance was the wish to know their HIV status. However, some managers of FSW worksites urged FSWs to be tested, curtailing FSWs' free decision‐making. One year later, status disclosure was common (90% of the 198 individuals who knew their results among those who participated in the follow‐up part of the study). Positive consequences of testing were far more frequently reported than negative consequences (98% vs. 2%, respectively). Negative life events included banishment from the worksite (one case) and verbal abuse (two cases).
Conclusion
Acceptability of VCT appears high in the FSW population in Conakry as a consequence of both perceptions of high individual risk and social pressures.