Sexually transmitted infection service use and risk factors for HIV infection among female sex workers in Georgetown, Guyana

Objectives: To identify risk factors for HIV and sexually transmitted infection (STI) service use patterns among female sex workers in Georgetown, Guyana. Design: A cross-sectional study was conducted among 299 female commercial sex workers. Methods: HIV prevalence was assessed using an oral fluid test, and sociodemographic and behavioral data by interview administered by sex workers and women's group members. Results: HIV prevalence was 30.6% [95% confidence interval (Cl) 24.9-36.3]. Multivariate logistic regression found a significant association between HIV infection and having a vaginal ulcer in the last 12 months [odds ratio (OR) 4.0, CI 1.4-12.0]. Having had a vaginal ulcer was associated with use of cocaine. Multivariate logistic regression on STI service use variables found significant associations between HIV infection and getting condoms from public sector STI services (OR 3.1, CI 1.6-5.8), not going back for HIV test results (OR 3.4, CI 1.1-10.1), and last getting tested for HIV more than 6 months ago (OR 2.8, CI 1.3-6.2). Conclusions: An active program of screening and treatment of ulcerative STIs should be combined with substance abuse services for sex workers (SW). Condom promotion services are reaching SW at high risk, but HIV stigma may prevent SW at high risk from accessing HIV test results.