To browse Academia. Given this context, there has been limited research on specific HIV risks. Robust Poisson regression was used to model weighted prevalence ratios PR for HIV, leveraging a modified social ecological model. The HIV prevalence among participants was Both individual and structural determinants involving stigma were significantly associated with HIV.
In a population of approximately 2. However, the risks of HIV infection are not evenly distributed throughout the country with urban areas, including Maseru, Leribe and Mohale's Hoek, having a higher prevalence of HIV [4]. Notably, in Lesotho and other countries in southern Africa, specific key populations including female sex workers FSW have been observed to bear higher burdens of HIV even in the context of broadly generalized HIV epidemics [5][6][7][8].
Specifically, the burden of HIV among FSW across low and middle income countries is approximately 14 times higher compared to other women of reproductive age [7]. While there has been less study of sex workers in southern Africa, where data are available, higher burdens of HIV have been consistently observed and associated with lower socioeconomic status, high levels of violence, and increased barriers to negotiating safe sex [8].
Individual determinants of HIV infection in previous studies included age and number of years selling sex in South Africa, Botswana, and Swaziland [5,6,9]. Moreover, network level characteristics among FSW, such as social cohesion or dynamics with clients, have mediated HIV risks [10,11]. However, in Lesotho, there are limited data to identify specific HIV prevention and treatment needs of sex workers [1]. The Government of Lesotho completed a study which found that starting sex work at a younger age and lower levels of education were found to be significantly associated with self-reported HIV infection [12].
This study also found that just over one-third of FSW used condoms regularly with their clients [12]. Thus far, limited studies examined how structural-level determinants-particularly stigma may mediate HIV risks among sex workers.
